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Does using a Medicare Broker truly benefit me?

Updated: Apr 1

Having been in the Medicare industry for over 17 years, I can attest wholeheartedly that using an independent Medicare broker will benefit you. The best news is that it doesn't cost you a penny to work with an agent.

Top 5 reasons to use an agent:

  1. Agents have a duty to you to provide unbiased and impartial recommendations. They are also compensated when you enroll in a plan. For this reason, working with a tenured agent who represents the majority of the plans in your area benefits you. By representing many plans there is no financial incentive for them to sway you toward a plan other than the one that is the absolute best for you.

  2. Regardless of how you enroll in a plan -, agent, call center, mail - the medical benefits are covered with you, including premiums, deductibles, copays, networks, and medications. There is SO MUCH MORE to your plan that probably don't realize. A great agent follows up after enrollment and after the plan begins. They can share a ton of cost-saving tips with you. Are you eligible to have your medicines shipped to you at no copay? Can you earn gift cards for getting an annual physical? Who do you contact for a ride to the doctor's office? Where can you spend over-the-counter and healthy food credits? How does your dental plan work?

  3. Health insurance is complex. All of us have received an explanation of benefits or claim from a doctor that didn't seem quite right. You can spend hours on your plan's phone tree only to be transferred a dozen times and subsequently disconnected or you can take the easy route and reach out to your agent for assistance. Agents simplify the claims process. Most health plans allow agents to submit claims inquiries through specific portals, emails, or escalated phone lines.

  4. During the Annual Enrollment Period, which starts October 15th and ends December 7th, seniors and other Medicare beneficiaries are inundated with mailers, commercials, Facebook ads, and more. Ignore them! Your agent will review your plan annually and tell you if it is still the best one for you. Medicare Advantage plans are competitive and incredibly innovative. What was best for you last year may not be best for you next year. Do you have a chronic ailment that is now covered under a new CSNP? Does your plan participate with the Senior Savings Model? Have formularies or networks changed? Are the copays and maximum-out-of-pocket stable next year? Are there new plans in the area that would benefit you more?

  5. Prescription drugs are tricky. Not only does the basic Part D plan constantly change - your medicines change throughout the year too. And, the companies can really do some harm to the members who don't read the Annual Notice of Change. This is where you see what the new year's premiums, deductibles, and copays will be. Unless you've really studied Part D, you probably don't realize that this is also a time when medicines can be deleted from the drug list or shifted into a new tier that changes the pricing. Savvy beneficiaries review their Part D coverage. A great agent will do this work for you.

Caution! Not all agents are created equally. Part of an agent's commission is devoted to service and follow up. Great brokers reach out to their members throughout the year with updates and helpful information. During the enrollment periods, they should take the burden of research off of your shoulders. If this sounds unfamiliar, I encourage you to shop around for a new Medicare broker rather than just a new plan.

Our agency has 19 years of experience in the Medicare realm. We are happy to answer questions for members and non-members alike. There is never a fee for our service and we offer unbiased advice in 31 states.

By Amanda Matthews, Agency Owner

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