From Medicare to Medicaid, Veterans’ Benefits, long-term insurance, and a wide range of other coverage options, there are many sources of support for your senior’s medical needs. But how do you navigate the complex world of medical insurance? Make no mistake, it can be confusing and time-consuming to determine what your senior might be eligible for, how to apply for certain coverage, and what makes the most financial sense. We all know that the insurance industry is famous for mind-boggling “fine-print” and legalese. This undertaking becomes even more challenging when you’re simultaneously juggling a full-time job and other family obligations.
Fortunately, there are dedicated professionals who can guide you through this process. Not only can Medicare and health insurance brokers educate you about the coverage available to your senior, but they can also help you choose the best options. This could save a considerable amount of money while providing your senior with increased access to important, potentially life-saving medical services. According to numerous studies, continuous insurance coverage is associated with better health outcomes. Best of all, the services of a Medicare insurance broker are completely free – so there’s no reason not to at least consider their advice when it comes to senior care.
Seasons created this guide to help you learn more about the ins and outs of Medicare brokers, including how they work and how to locate the most qualified professionals for your senior’s unique needs. In addition, our Resource Hub provides you with a directory of the best Medicare brokers in your area, allowing you to quickly and efficiently assess your options. The Resource Hub is filled with all kinds of other local senior care options as well, including adult day care, geriatric care management, and much more.
Medicare brokers – a free way to maximize senior health coverage
What are Medicare brokers?
Medicare brokers represent insurance companies, but they are not beholden to any particular organization. Instead, their job is to help you understand options and choose the best coverage plan and insurance products based on your senior’s unique needs and requirements. Although they are incentivized to sign you up for some kind of coverage, they are generally considered impartial, independent agents within the insurance industry. This is because they won’t push one insurance company over the other unless it is truly the most logical option for you.
Are Medicare brokers really free?
Yes, you won’t pay a dime for consultations with your Medicare broker. Instead of charging you money, these professionals get paid by insurance companies after they help you choose a particular coverage plan. They earn either a percentage or a flat-fee commission based on the value of the plan.
What’s the difference between a Medicare broker and a Medicare insurance agent?
It’s important to understand the differences between a broker and an agent. They may seem pretty much identical at first, but Medicare insurance agents only represent one insurance company. As such, their goal is to sign you up to a plan offered by their company – even if another company offers a more suitable plan.
In contrast, Medicare insurance brokers operate as independent agents and represent a range of different insurance providers. This means that they help you choose from a wider selection of health insurance plans and plan options based on your senior’s unique needs and priorities.
Brokers and agents are knowledgeable, so it can be helpful to consult with both. Just be aware of any financial motivations as you and your senior consider plan options.
Why would my senior need a Medicare broker?
You might be wondering whether you and your senior truly need a Medicare broker. After all, can’t you just research the insurance options on Medicare.gov and pick the best one? Here are some potential reasons to consider a Medicare broker:
- You don’t have time to research insurance options
- You’re unsure about how Medicare works
- You have questions about specific policies
- You can’t find the right plan options for your senior’s unique health care needs
- Your senior is on a limited budget, and they need to get the most “bang for the buck”
- You can’t make sense of the complicated vocabulary used in policy descriptions
- Your senior is completely uninsured
For example, you might be unsure about the differences between Medicare plans. Part A (for hospital insurance) is mandatory for adults over the age of 65, and Part B (for medical insurance) is optional. Both Part A and Part B are run by the government. Beyond these, there is Medicare supplement coverage run by third parties. Part D, for example, helps with the cost of prescription drugs. Part C (also known as Medicare Advantage) provides additional perks like vision, dental, and prescription drug coverage but limits you to a network of providers like a traditional health care plan. Plan G is also known as Medigap, and it offers a standardized pricing system that doesn’t change regardless of which insurer you choose. These are just a few of the offerings.
In addition to helping you understand all of the options, your Medicare broker will also help you explore differences in supplemental Medicare coverage from providers such as Aetna, Humana, Blue Cross Blue Shield, Cigna, and United Healthcare.
According to recent Census data, there are almost one million uninsured adults over the age of 65 in the United States. Many of these individuals never completed enrollment because they simply can’t figure out this complex system. A Medicare broker can help Medicare beneficiaries make sense of it all.
Questions to ask yourself as you consider Medicare brokers
If you’re still not sure whether a Medicare broker is the right choice for you, ask yourself the following questions:
- Do I have time to spend hours researching different insurance plans?
- Do I truly have the expertise necessary to choose the best plan for my senior?
- Is saving money on health care coverage an important priority for my family?
Despite the benefits of Medicare, only 18.4 percent of people in the United States are currently enrolled. This leaves many seniors and family caregivers vulnerable to all kinds of costly medical expenses with any protection whatsoever.
What services do Medicare brokers provide?
Medicare brokers can provide quick results
When you’re caring for a senior who needs health care coverage for medical conditions, time is of the essence. One of the key benefits of working with a Medicare insurance broker is the fact that they can expedite the selection and enrollment process, helping your senior get the health services they need as quickly as possible.
When working alone, family caregivers might spend hours sifting through various plan options while trying their best to make sense of complex coverage details. When you work with a Medicare and health insurance broker, you can rely on their expertise and select the best health plans in a short amount of time.
Medicare brokers provide you with an opportunity to ask questions
When researching health plans on your own, you’ll likely be visiting Medicare.gov and other sites in an effort to learn about different companies and insurance plans. But internet research only gets you so far. When you’re scrolling through a website, you don’t have the opportunity to ask questions based on your senior’s unique needs. Each senior is different, and the nuances of each situation often justifies personalized guidance.
A meeting with a Medicare broker occurs in an organic, face-to-face environment where you’re free to ask as many questions as you like. A broker will listen carefully to your senior’s specific health care concerns and suggest plans that provide the most cost-effective, targeted financial support for treatment that your senior actually requires.
Medicare brokers help you understand the differences between policies
One of the most difficult things about choosing health care insurance is comparing different policies. The differences between policies can be subtle, and the best plan might not be clear to the untrained eye. Insurance companies are highly competitive with one another, offering health plans that seem almost identical at first glance.
With help from a Medicare broker, you can break down these differences in a way that is easy to understand. Medicare and health insurance brokers use a variety of strategies to accomplish this, including visual tools like side-by-side graphs or tables. Often, you’ll realize that two Medicare supplement plans that seem identical are actually very different – with one being the clear winner.
Questions about Medicare brokers
What types of services does a Medicare broker provide?
- In-person consultations
- Explanation of health plans and plan options
- Ongoing communication
- Enrollment assistance
- Contact information for insurance agents and benefits representatives
- Educational materials
- Guidance on how to file claims
How do I know if I can trust my Medicare broker?
Medicare brokers are fully licensed agents with a number of qualifications under their belt. In order to become a Medicare insurance broker, you must gain the necessary certifications, education, and on-the-job training required by your state. Each state has slightly different requirements. Anyone wishing to offer Medicare Advantage plans or Part D prescription drug plans is required to complete specialized training each and every year.
Most states accept the AHIP certification training. AHIP is considered the “gold standard” when it comes to Medicare Advantage certification, and applicants must receive a score of 90% or higher in order to pass. If they fail the test or neglect to take it, they are legally prohibited from offering any Medicare plans within that calendar year.
You can verify that any Medicare and health insurance broker you’re communicating with has current certification with a simple web search.
Do Medicare brokers ensure plans are compliant?
Yes, one of the key responsibilities of Medicare brokers is to ensure that your insurance plan is compliant with both state and federal laws. This helps you feel confident about your plan, as you won’t encounter any issues going forward in terms of legality.
What questions should I ask Medicare brokers?
When meeting with a Medicare broker, you might want to ask them the following questions:
- How long have you been a Medicare broker?
- What kind of certifications do you hold?
- How will you find the right plan for my senior’s unique medical needs?
- Is my senior’s current plan changing?
- Are there new benefits or new plan options that I should be aware of?
- What is covered in my senior’s plan (prescription drugs, vision, dental, etc.)?
- What is the plan’s annual out-of-pocket maximum?
- What are my senior’s total annual costs?
- Can my senior switch if they don’t like their new plan?
What kind of questions will a Medicare broker ask me?
Your Medicare broker will also ask you a number of questions during your meeting, including:
- Is this your first time purchasing Medicare for your senior?
- Do you want to switch from an existing plan?
- How often does your senior see a doctor?
- How often does your senior see specialists?
- Does your senior take prescription drugs?
- What’s your budget when it comes to medical treatment?
These are the most basic questions your broker should be asking you, but they may ask many others based on your senior’s unique circumstances.
Talking about Medicare brokers with your senior
Your senior may be somewhat resistant to enlisting the services of a health insurance broker, especially if they believe that no changes are required. Explain to your senior that these professionals can help you choose the most financially-sound and effective health insurance options, reducing the burden on the entire family and improving their well-being.
You might need to explain that very little will change in terms of their health care, and that a new plan might actually give them access to new care options that were impossible previously. Another important point is that they will almost always continue to see the same family doctors and nurses that they’ve grown to know and trust.
That said, if you do opt for a particularly enticing Medicare Advantage plan, coverage will now be tied to a specific network of providers, so make sure you’ve talked this over with the senior and they understand the implications. And as much as you can, conduct meetings with your Medicare broker in the presence of the senior.
Paying for Medicare brokers
How much do Medicare brokers cost?
Medicare brokers shouldn’t cost you a single dime. If Medicare brokers do attempt to charge you for their services, this is a red flag. The fact that these services are free makes it easy to convince seniors and other family members to make use of this effective resource.
How can I find Medicare brokers?
When you’re ready to assess your options for nearby Medicare brokers, Seasons is here to help. Our Resource Hub offers a range of options for Medicare and health insurance brokers in your area, allowing you to connect with a reputable, qualified professional and begin improving the overall well-being of your senior as soon as possible. Check out the Resource Hub today and start making smart financial decisions with the help of an experienced Medicare insurance broker.