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 acting as you own agent.

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 if you choose not to be your own agent. Both desirable and undesirable agents are licensed by the state and certified by the insurance companies regulated by the feds. The fact that agents are licensed and certified means only 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 and represent as many plans as possible. Many such agents try to possess the legal authority to enroll you with the majority of insurance companies in your area. Representing most companies gives such agents the greatest opportunity to align your needs with a good 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 a single or only a few Medicare-Advantage companies or Medicare-Supplement companies. 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 will receive from the agent, from her or his employees, or 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.) Below are some post-enrollment issues you will want to consider discussing with independent 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 to see if I need something?

      • Good agents should re-verify that your medical providers still accept your insurance.

      • Good agents should review your drug coverage once a year to see if your current plan's pricing is still most or nearly most competitive since drug costs are potentially the most harmful and most predictable aspect of your financial health.

      • Good agents should review your coverage's design every year since Medicare Advantage plans are changing ancillary coverage like dental benefits, chiropractic, hearing aid, and other coverages every year.

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

    • How fast will you answer when I leave a message?

    • Will you keep me proactively informed when coverage changes will affect me?

  • Beware of some marketing messages from insurance agents. To explain what we mean, we need to use some marketing lingo. 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. They can persuade you of this if they use diversionary tactics like easy-to-use technology or have pleasing personalities. But you have a choice: you must ensure either that the agent is trustworthy or that the plan is in your best interest. You may need to ensure the trustworthiness of the agent one time, and you will need to ensure the suitability of the plan every year if you do not know that you can trust your agent to have your best interests at heart. Lift Advocacy 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 whether you use an agent or not. The federal plans can be changed 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.