12 Reasons Why Every Retiree Should Have a Medicare Agent

Medicare is the federal health insurance program for Americans 65 or older, and more than 66 million people use it for their health care. It can be a life-saver — literally — but just like health insurance for younger people, it can be very confusing. Insurance agents who specialize in Medicare can help seniors make sense of it all, but many people don’t even know that agents are available to help them. 

Here’s why you should find yourself a Medicare agent for the upcoming annual enrollment period that starts on Oct. 15.

Just like insurance agents for your car and home insurance, agents who specialize in Medicare offer their services for free. “Independent agents are compensated by the insurance companies when they enroll you,” says Keith Frankforter, a licensed independent Medicare agent. “But we get paid the exact same no matter what company or plan you sign up for, so we’re unbiased. We work for our clients, not the insurance companies.”

Medicare brokers — another name for agents — are licensed in the states or regions they do business in. They must pass proctored exams and are certified by each insurance carrier. Every year, they must recertify to keep their license, so they’re always up to date on the latest information from the government and insurance companies.

There are all kinds of ways scammers try to get money out of you, and many fraudsters target people on Medicare. Some scams include COVID-19 testing fraud, fake diabetic supplies, and even commercials on TV, especially during the annual enrollment period. If you’re not sure if something is a scam, your insurance agent can verify and report the scammers if necessary.

“Never give out your Medicare number over the phone to someone you’re not familiar with, especially if they claim they’re ‘from Medicare’,” warns Frankforter.

If you’ve used employer-provided health care, you might think that Medicare is just as simple as choosing one of the few options you’re given by your employer. But Medicare is more complicated in many ways because there are many more variables and options. It can be jarring to switch from employer-provided health care to Medicare after you turn 65, so it’s great to have an agent to help navigate it with you.

The fact that Medicare is so complicated means that many people are on plans that might not be the best for them. Independent agents can compare all the plans and supplements available to you and present you with many options from a number of insurance carriers. They can also help you choose the right ones based on your doctors, medications, and specific circumstances.

Part of choosing the right health care plan is making sure it fits in your budget. Agents can discuss premiums, the price of your medications, and how variables such as your age and gender can affect the total amount you’ll be paying. Sometimes, they might even be able to find you a plan that better suits your needs for less money.

Having a Medicare agent is like having a personal health care assistant. They find the best coverage options for you, saving you time in researching each one on your own. “Researching Medicare for yourself is extremely difficult if you’re just starting out,” says Frankforter. Everyone’s time is valuable, even when retired.

Like any insurance policy, you’re bound to have tons of questions both before you sign up and while you’re covered. Use your agent’s experience and knowledge as an asset to help you understand your health care better.

No one likes dealing with insurance companies, especially during difficult health crises. Depending on your agent, they may be able to help you determine if there are problems with claims or billing. They may have direct contacts at insurance companies to cut through some of the frustrating red tape we all have to deal with.

When you’re looking for a Medicare agent, make sure it’s an independent broker. Some agents work for insurance companies, and they’re called captive agents. They’ll only be able to offer you insurance from the company they work for, which isn’t in your best interest. Independent agents, however, will compare health care coverage from many different providers to find the best and most affordable options.

Plans and coverage change every year, so if you haven’t taken a closer look at your Medicare plan in a number of years, chances are there might be a better option for you now. Many agents do an annual policy review for their clients to ensure you’re getting your needs met and the best deal.

Having a Medicare agent right now is especially important, according to Frankforter. That’s because changes from the Inflation Reduction Act of 2022 go into effect for 2025. The most significant is a $2,000 out-of-pocket cap on prescription drugs that will have a ripple effect on Part D and Medicare Advantage plans. “This is the first time in a long time that Medicare is changing so significantly,” says Frankforter. “So even if you don’t normally review your policy every year, it’s important to do it this year.”