Identifying and Managing a Good Medicare Agent

Choosing a good independent agent is the most important decision that you can make unless you are going to act as your own agent and enroll yourself. Agents are supposed to help you with enrollment decisions and post-enrollment service issues. The insurance companies pay agents to continue helping you for as long as you remain on the plan. You will remain their client until you enroll in a different plan through a different agent or by yourself.

Lift Advocacy wants to describe the type of agent that you will want to work with and the type that you will want to avoid. All of them will be both licensed by the state and certified by the insurance companies that have relationships with the federal and state governments. The fact that they are licensed and certified only says that they possess the knowledge to help you, not that they have the character to help you in the way that you would like to be helped. If you want to work with a local agent to save yourself time and frustration, you need to identify and select someone who has both the right knowledge and the right character to be your agent.

Advice for Identifying, Selecting, and Managing a Good Medicare Agent

  • Deal with independent agents who own their businesses. Such agents usually try to possess the legal authority to enroll you with the majority of insurance companies in your area. Representing so many companies gives them the greatest opportunity of aligning your needs with a local plan. The knowledge of independent agents regarding all the plans in the area promises to give you the most satisfaction as you make decisions—provided that the agent believes that his or her primary responsibility is to serve you rather than maximize his or her own convenience.

    • Some agents who appear to be independent agents by owning their own businesses are really captive agents. Such agents represent only a single Medicare-Advantage company or a single Medicare-Supplement company. Captive agents are trained to see your situation in a certain light that will require a solution from the single company they represent. This is quite a different approach to listening to your situation, determining which aspects of your situation you find most important, and then presenting the possible plans from any company according to your own determinations of what is important.​

  • Enroll in Medicare through an agency or agent where you can talk directly to the business owner and negotiate the post-enrollment level of service. It is by discussion with the decision-maker that you can assess and confirm the level of service you receive from the agent, from her or his employees, and from their technology. (You cannot speak to the people who make decisions about service levels if you enroll through large call centers, captive agents, or phone-apps.) Here are post-enrollment issues you will want to consider discussing with local agents before you enroll with their help:

    • Will you provide me with advice or work on my behalf during disputes with insurance companies and government agencies?

    • Will you answer all of my questions until I feel satisfied?

      • You can always contact Lift Advocacy for education apart from your agent​.

    • Will you contact me twice a year, once for the annual enrollment period and one other time?

      • Re-checking your medical providers to ensure they are still in network.

      • Reviewing your plans every year, especially your drug plan since this has the most predictable and potentially harmful result on your financial health.

    • Will you answer when I call?

    • Will you return my calls and answer my email messages and texts?

    • Will you keep me informed when things change that affect me?

  • Beware of some marketing messages from insurance agents. May we use some marketing lingo to explain what we mean? More and more Medicare marketers are trying to convince you that a shopping good, the type of product that requires initial and perhaps ongoing or annual research, is a convenience good, the type of product that does not require research. In other words, some people who can enroll you in Medicare will try to convince you to simplify your lives by pretending that enrolling in Medicare plans is as easy as buying milk and bread—if you have the right technology or the most likable agent. They will try to persuade that you do not need to understand more than what is necessary to fill out an enrollment application right now, that you do not need to bother with the research either to enroll yourself or to identify a good agent. Lift would like it to be clear in your mind that Medicare plans are always shopping goods and that you will need to be mentally engaged in choosing the right one for your circumstances. They change every year between Oct 1 and Dec 7, and a good agent will learn how the changes will affect you in the coming year.

    • There is an easy but misleading way of choosing a Medicare plan, a way that many are finding persuasive—much to their regret over the course of the following year. The way is so tempting because it reduces the stress around Medicare decisions to be made over the next few days or weeks. The way involves selecting the insurance company whose brand you most trust and then selecting the plan with the lowest premium amount. This approach is easy but avoids the necessary complexity of checking drug costs and doctor participation in the insurance-company's provider network. This approach is generating high costs and a lot of frustration for a lot of people. The approach saves people a few hours of learning upfront but then costs them a lot in drug costs over the course of the following year.

  • There are many good agents, but we cannot vouch for all of them, so we ask agents in your neighborhood to sign a commitment to follow certain rules that we at Lift Advocacy believe defines a good agent. We call it Lift Advocacy's Code of Integrity.