Should I Use a Medicare Advantage Broker?

What is a Medicare Advantage broker?

Private insurance plans, including those under Medicare Part C, have different premiums and coverage.

While enrollees usually pay the Part B premium, some Part C plans may cover this cost. Some Part C plans include coverage for prescription drugs, while others do not. In addition, some Part C plans offer additional benefits like vision or dental.

Selecting the best plan for you can be challenging since this decision depends on many factors. Insurance brokers can help you evaluate the options and assist you in enrolling in your chosen plan, potentially saving you time and money.

Why do brokers push Medicare Advantage plans?

Understanding how insurance brokers work and how they differ from insurance agents is important.

Insurance agents are usually hired and compensated by the specific insurance company they represent, while insurance brokers receive compensation from several companies they partner with.

An agent recommends only plans offered by their specific company. A broker collaborates with numerous insurers and earns a commission once they successfully enroll a client.

With brokers, you don’t have to pay anything for their services. But the recommendations they give you may be influenced by their compensation, potentially excluding certain plans that might work better for you.

For example, brokers are incentivized to advise people to join a Medicare Advantage plan rather than stay with Original Medicare because their commission is higher for Medicare Advantage. Plus, in a survey of brokers from 2023, some participants reported that because Part D commissions were so low, brokers had less incentive to help people with Original Medicare reevaluate their Part D plans each year.

For these reasons, the services of an insurance broker or agent are not suitable for everyone. If you’re not interested in working with a broker, you can use Medicare’s Part C plan comparison tool, which allows you to enter your ZIP code and see the plans available in your area. From there, you can enroll in the plan of your choice.

What should I expect when meeting with a Medicare Advantage broker?

The Centers for Medicare & Medicaid Services (CMS) has rules regarding what insurance brokers can and cannot do when making recommendations for Medicare plans.

Brokers are allowed to:

• provide you with plan materials
• explain how to access additional plan details
• discuss the plan options you wanted to review
• provide an enrollment form and gather the filled-out form
• leave business cards for you to share with friends and family

Brokers are not allowed to:

• share information about other plan options unless you specifically ask about them by filling out a special form
• sell you anything unrelated to healthcare, like life insurance, during a meeting about Part C plans
• offer cash or gifts over $15 in value
• request your credit card or banking details
• place pressure on you to join their plan
• ask for names, phone numbers, or addresses of your friends or family

How do I pick a Medicare Advantage broker?

If you decide to work with a broker, you should ensure the company is licensed to sell Part C plans in your state.

You can then examine reviews and ratings of the company you’re interested in. Some review websites include TrustPilot and the Better Business Bureau (BBB).

In addition, you can consider choosing a broker based on referrals from family and friends or from your healthcare professionals. Examples of Medicare broker services include SelectQuote and Hello Medicare.

Takeaway

When it comes to Medicare, a broker can assist you in choosing and enrolling in Medicare Advantage (Part C), Part D, and Medigap plans. These plans are administered by private insurance plans, which means their costs and benefits can vary.

That said, how brokers receive compensation can affect their recommendations, so it’s important to weigh this information when deciding whether using a broker is the best choice for you.