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Why Work With an Independent Fee Only Medicare Advisor?

There are three critical reasons why you should consider working with a fee-only Medicare advisor.

Unbiased Advice (if you don’t read anything else, read this!)

The governing body of Medicare, Centers for Medicare and Medicaid (CMS) recently made a much needed update to the marketing guidelines that insurance agents must follow when marketing selling Medicare Advantage plans.

To summarize, it states that when agents are soliciting for new clients, they must disclose that they do not offer all plans in your area and therefor can only advise you on the plans they are approved to sell.  This is because it’s impossible for any broker in any area to represent all plans.

This can create a conflict as the broker you are working with may not represent the best plan for you in your area and subsequently sell you something different.

This is absolutely the most important reason you should consider meeting with a fee-only Medicare Advisor.  You’re paying for transparency around options available in your area as well as pros and cons regarding your specific scenario.  Fee-only Medicare advisors are never afraid to tell you what you don’t want to hear because they are not trying to earn a commission, they are giving you the information you are entitled to.

The planning process is much smoother when the stress of the sale is completely removed and when you find the right plan, the advisor will help you get connected to the enrollment solution to ensure you’re in the plan that works best for you.

Medicare and Social Security Expertise.

If you are new to Medicare, the choices you face may feel a bit overwhelming and you’re sure to have questions about what’s best for you.  For example, people turning 65 and still working and covered by an employer’s group insurance plan need to understand that Medicare is different in terms of benefits, costs and the providers you can access.  Additionally, if they continue to work, how does that impact amount of their social security income that will be taxed? How does it affect the cost of your part B premiums?  Deep knowledge about Medicare and social security is critical and perhaps is the biggest benefit.

Take the time to do it right.

Fee only advisors take the necessary time to educate you, answer your questions, and make you feel valued and included in the selection process.  Medicare and social security are complex and take patience, it’s not easy for everyone and you need to work with someone that isn’t going to prioritize the amount of time they give you based on their ability to win a sale.

How does our fee-only Medicare planning process work?

It’s actually very simple, below are the steps.

  1. Conduct a Medicare 101 session: Consultants will educate you on the basics of Medicare and determine through detailed fact finding what is most important to you regarding your healthcare.  For those turning 65, this session will also include elements of social security planning as well so you understand how your income impacts what you pay for Medicare.
  2. Current plan review: We will discuss your current benefits and identify what you like, don’t like, and would consider changing if you could.  This interactive discussion proves to be one of the most valuable parts of the planning meeting as it brings together the Medicare basics and how they directly impact your healthcare situation whether your transitioning to retirement or switching to a new Medicare plan.
  3. Review plans available in your area:  Not all plans are created equal and just because a plan is available in one county doesn’t mean it’s necessarily available in the next county.  We will review all plan types available in your area and discuss any specific eligibility requirements as well as pros and cons. This is the time we deep dive into details to make sure plans are meeting your specific needs.  If we have to review 10 plans, then we take the time to review 10 plans to make sure you are comfortable.
  4. Produce your customized Medicare report.  Upon completion of the planning meeting we will generate a report in roughly 48 hours for you that summarizes the information, recaps the information most important to you, and lastly, make plan recommendations based on the plans we reviewed together and instructions for enrollment to ensure you are getting connected the plan that is right for you.

Frequently Asked Questions (FAQ)

How does enrollment work?

Once you have completed the planning meeting with us, your customized report will provide detailed instructions for how to enroll in the plan you are most comfortable with that meets your needs.

Based on the plan you wish to enroll in, your Medicare consultant will match and provide you with licensed agents approved to sell the plan you are requesting to enroll. This means you don’t have to go find someone yourself, we’ll do the heavy lifting for you and make a strong and vetted introduction for you.

We’re here to support you and make this entire process pain free.

What if I don’t want to work with a fee-only Medicare advisor?

That’s absolutely okay, working with a fee-only Medicare advisor is not for everyone and we understand and respect that.

Here is how you can find commission only independent Medicare brokers near you as well as additional, relevant information.

  • Ask for a referral. If you have car insurance, homeowners’ insurance or life insurance, contact your agent or financial advisor and ask for a referral to a Medicare broker.  They usually know someone local.
  • Go online. It seems obvious, but if you know what to look for, this can do a lot of the heavy lifting for your initial efforts.  You should plan on doing additional vetting after you’ve uncovered several agents who appear to meet your needs.
  • Independent vs Captive. Make sure you search for “Independent Medicare agents near me” instead of limiting your search to captive agents.  Unlike captive agents, independent agents are not tied to one or two insurance companies and will be able to offer the best, broadest and most unbiased information and advice based on your unique situation.
  • Confirm AHIP certification. In addition to being licensed to sell insurance in a specific state, to sell certain Medicare plans an agent must also pass an annual American Health Insurance Plans (AHIP) certification exam.  AHIP certification is administered by the trade association that specifically represents the health insurance industry.  Agents are required to demonstrate specialized Medicare knowledge to pass the exam and must pass on an annual basis.

What Kind of Medicare Consultant Do You Need?

Once you have made the decision to work with a Medicare agent, the following are several things to consider.

  • Active. You want an independent Medicare agent who is actively selling Medicare and maintains regular communications and updates with legislative changes, insurance company news, market-specific news and other changes.
  • Specialization. The more time an agent devotes to Medicare, the better it is for you.  A jack-of-all-trades approach is a pale comparison to someone who makes Medicare plans the focus of their efforts.
  • Good reviews. Once you’ve narrowed your search, conduct an online search to see if there are any complaints that have been filed against an agent.  Similarly, also look for positive reviews as well, keeping in mind that this should just be one of many things you consider.
  • Properly licensed. Along with being licensed to sell insurance in your state, they should also be AHIP certified as well.  This is the trade organization that ensures Medicare agents have required training and knowledge to best represent your interests.
  • Responsive. Expect your agent to be responsive. If you’re having a hard time getting answers or a reply from an agent, move on to someone else.  There’s too much competition out there to have anything less than a top-notch experience.
  • Service after the sale. Ask about whether there will be an ongoing dialog with you above and beyond just an annual review of your policy.  Good agents will build a relationship with you and stay in touch proactively to make sure you are always in good standing.

How Do Medicare Agents or Medicare Insurance Brokers Work?

An independent Medicare insurance broker or agent helps consumers apply for and enroll in Medicare insurance coverage. Independent agents will offer options from many different companies.  An insurance broker that is licensed to sell Medicare plans can help you find coverage through Medicare-contracted private insurance companies.  It’s important to note that a broker or agent doesn’t provide direct coverage—benefits are still administered through the actual Medicare plan that you choose.

One of the key benefits of working with an independent agent or broker is they are not tied to a single plan.  This means the broker has all the information on several plans in a single one-stop place for you.

Do I Need a Medicare Consultant to Sign Up for Medicare Advantage?

No.  You do not use a consultant to sign up for Medicare advantage, you need to use a licensed agent who is ready to sell for the current plan year with the plan you are choosing.

An agent who works in the industry every day has added insights and first-hand knowledge that no amount of online digging will uncover.

Doing the research on your own might produce a good result, but you are also gambling with your health care coverage this way and it is just as likely that you could end up with the wrong coverage, lesser coverage or a plan that forces you to pay more than you would have done so otherwise.

This is one reason fee-based planning is so effective.  You can take your customized planning report and plan recommensation to any licensed agent appointed to sell the plan you have selected.

How Do You Pick an Unbiased Medicare Consultant Near You?

Just as it is with any major decision, the more work you do up front, the more likely you are to end up with a good result in the end.  Finding an unbiased Medicare agent near you will require effort on your part, but the results should be worth it.

To begin, cast your net wide.  Start by searching the Internet using keywords such as “Medicare agent” or “Medicare consultant” plus the city or region where you live.  This should give you a good starting list.

You might also try contacting a state health insurance assistance program.  This can be done through the State Health Insurance Assistance Programs National Network that provides local Medicare help with trusted, unbiased, one-on-one counseling and assistance.

Your next step will be to pare the list down.  One of the best ways to do this is to find an agent who specializes in Medicare plans.  But how can you tell which ones specialize? Most insurance agents offer a variety of insurance coverage ranging from home, auto and renters, to life and car insurance and so on.  In other words, they may know a fair amount about Medicare plans, but their time and knowledge are split in many different directions.

A good tip-off that you’re going to work with a Medicare specialist is to look for someone who not only markets themselves this way, but who is also properly licensed to sell Medicare plans and has passed their annual AHIP (American Health Insurance Plans) exam.  This exam is administered by the trade association that specifically represents the health insurance industry.

Narrow your search further by looking for an independent agent instead of a captive agent.  An independent agent represents many plans, while a captive agent will typically represent only a single carrier, possibly two at most.  Having a large portfolio of Medicare plans allows a Medicare adviser to fit the plan to your unique needs.

Also look for an agent who charges a flat fee or an hourly rate.  An agent who is paid by commission may have an unintentional conflict of interest even though they may have your best interests in mind.  There are also agents out there who will charge no fee at all.

Pick the top two or three agents based on these criteria, and you should have a good experience in making a final decision regarding your choice of a Medicare plan.

Examples of Medicare Agents and Plans by State

We picked four of the larger states in the United States and have given you some specific contact information on how to find Medicare agents for these areas.

We’ve also listed all of the Medicare plan providers for each of the four states so that if you are a resident, you can begin researching individual companies if that is your preference.

Medicare Agents in California

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states.  This is a free service for consumers.   To access the locator tool, go here.

The California Department of Insurance also maintains a consumer page to assist residents in finding an appropriate broker.  It lists several trade associations and if you are not fluent in English, there is also an Agent Language Locator so that you can find a broker that speaks your desired language.  To access the page, http://www.insurance.ca.gov/01-consumers/105-type/findagtbrk.cfm

The Health Insurance Counseling & Advocacy Program (HICAP) is run through the California Department on Aging and provides free and objective information and counseling about Medicare. Volunteer counselors can help you understand your specific rights and health care options. HICAP also offers free educational presentations to groups of Medicare beneficiaries, their families and/or providers on a variety of Medicare and other health insurance related topics.

To access a complete list of HICAP offices, go here, or call the California Department on Aging at 1-800-4334-0222.

California State Medicare Plans

Medicare Agents in Florida

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states.  This is a free service for consumers.   To access the locator tool, go here.

The Florida Office of Insurance Regulation provides a wide variety of consumer resources to assist people with several types of insurance, including Medicare.  To access this information, go here.

SHINE (Serving Health Insurance Needs of Elders) is a free program offered by the Florida Department of Elder Affairs and local Area Agency on Aging programs. Specially trained volunteers can assist Floridians with Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential.  The SHINE program supports the Florida Department of Elder Affairs’ mission by providing free and unbiased health insurance counseling through a dedicated network of volunteers, empowering Florida seniors to make informed health care choices.

Florida State Medicare Plans

Medicare Agents in New York

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states.  This is a free service for consumers.   To access the locator tool, go here.

The New York Department of Financial Services oversees a comprehensive website on all types of insurance issues affecting New York residents.  To access the NYS Provider and Health Plan Look-Up, go here.

The New York State Office for the Aging sponsors The Health Insurance Information, Counseling & Advocacy Program (HIICAP). HIICAP provides free and objective information, counseling, assistance and advocacy on Medicare, private health insurance, and related health coverage plans. HIICAP helps people with Medicare, their representatives, or persons soon to be eligible for Medicare.

To learn more about NYSOFA’s HIICAP program and how to access information, you can visit the agency’s programs and services page.

To contact a HIICAP counselor, call 1-800-701-0501 or visit the HIICAP local Offices page.

New York State Medicare Plans

Medicare Agents in Texas

The American Association for Medicare Supplement Insurance offers a free locator tool by zip code for agents in all 50 states.  This is a free service for consumers.   To access the locator tool, go here.

The Texas Department of Insurance operates the Texas Health Options website that allows consumers to compare health plans, benefits, networks and more.  To access the site, go here.

Texas Health and Human Services oversees the Texas Department of Aging and Disability Services.  If you are eligible for Medicare, the Texas’ Health Information, Counseling and Advocacy Program can help you enroll, find information and provide counseling about your options. This partnership between the Texas Health and Human Services system, Texas Legal Services Center and the Area Agencies on Aging trains and oversees certified benefits counselors across the state. Benefit Counselors are specially trained to help you find and apply for a plan that works for you. They advocate for you with these programs and help you get the services you need.  Call 800-252-9240 or visit their directory for an office near you.

Texas State Medicare Plans

The Best Medicare Plans Near You

Among the most important decisions regarding Medicare is whether your coverage should only be Original Medicare (Part A and Part B coverage) or if you will want additional coverage by purchasing a Medicare Advantage Plan (Part C coverage).  Some people also need or want Medicare prescription drug coverage (Part D coverage) or Medicare Supplement Insurance (Medigap).  If you join a Medicare Advantage Plan, you don’t need to purchase a Medigap policy.  In fact, if you have a Medicare Advantage Plan, it is illegal for a company to sell you a Medigap policy.

Medicare Advantage Plans are offered by private companies that contract with Medicare to provide Part A and Part B coverage and frequently offer enhanced benefits.  Medicare Advantage Plans include:

  • Health Maintenance Organizations (HMO)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans (PFFS)
  • Special Needs Plans
  • Medicare Medical Savings Account Plans

You can join a Medicare Advantage Plan if you live in the service area of the plan you want to join.  Not all providers offer plans in all areas.  You must also already have Medicare Part A and Part B.

There are many ways to find the best Medicare plans near you.  One source that offers a comprehensive comparison of the best companies by state is offered by U.S. New & World Report which has a five-star rating system that helps people to research various plans.  All plan information and star ratings come directly from the Center for Medicare and Medicaid Services (CMS) at Medicare.gov.  A Best Insurance Company for Medicare Advantage is defined as a company whose plans are rated as at least three out of five stars by CMS and whose plans have an average rating of 4.5 or more stars within the state.  To access the locator tool, go here.

Keep in mind that this is just one option you can access to research Medicare Advantage Plans.  You should undertake a variety of activities and take your time, including working with a Medicare agent, to help you reach the best possible decision for your coverage.

You can also access PolicyZip’s informative “Guide to Choosing and Changing Your Medicare Supplement Insurance” and “Special Enrollment Information for Medicare” articles to help educate yourself on your choices and options.