What is the difference between a medicare broker and a medicare agent?

Medicare brokers are often referred to as Medicare advisors or agents. In most cases, these titles are used interchangeably. In some organizations, these may be. In some organizations, these roles may be different, but in most cases they are different ways of referring to the same type of Medicare insurance professional. Medicare agents and brokers work differently, but both can help you eliminate confusion and find the best Medicare coverage at the best cost.

Agents work for insurance companies that sell Medicare plans, while brokers connect you to the agent or company that best fits your needs. A Medicare broker is an advisor who represents several insurance companies and can help you evaluate plan options, as well as help you enroll in a plan. A Medicare insurance agent is a licensed expert who helps you review and evaluate Medicare plans and their benefits, and guides you to choose the right one. Most brokers and insurance agents who advise Medicare beneficiaries say they earn much higher fees for enrolling people in Medicare Advantage plans than in Medigap supplemental policies, with some variations. All legitimate Medicare advisors, brokers and agents are certified by the insurance companies they represent, in accordance with guidelines established by the Centers for Medicare and Medicaid Services (CMS).

Another topic we heard was that a beneficiary's income often determines whether people sign up for traditional Medicare with a Medigap plan or a Medicare Advantage plan. Brokers and agents can earn additional income by evaluating the health risks of beneficiaries during the Medicare Advantage enrollment process. You'll have a single six-month period to enroll in Medigap without health insurance, starting when you're at least 65 and enrolled in both Part A and Part B. You can contact your agent or broker if you have questions and they can help you directly or point you in the right direction.

A Medicare agent or broker is well positioned to help you determine if you'll meet the subscription requirements of the specific plans you're considering. First, agents tend to have limited knowledge, while brokers tend to have much more knowledge and experience. Even so, it's important to ask your broker the right questions before you start to ensure that it works in your best interest. Brokers don't sell all the plans in their geographic area; they said they choose the plans they offer based on how quickly insurers respond to their questions, customer feedback and, sometimes, the benefits of the plan.

Quality of care, coverage and access, Medicare, Medicare Advantage, Medicare Part D and the health insurance marketplace. Brokers and agents said that some Medigap and Medicare Advantage insurers offer “substantial additional fees” when enrollment objectives are met. This is because they value the peace of mind that comes with knowing that nearly all traditional Medicare cost-sharing will be covered. Some said it was “obvious to them” that the government wants more people in Medicare Advantage plans.

Donald Dopita
Donald Dopita

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