How to Choose a Medicare Insurance Agent

Do you actually need a Medicare insurance agent?

You're not required to have one. If you skip an agent, you're generally on your own with an 800 number from the carrier directly, or whatever you can piece together applying through Medicare.gov.

With the right agent, you get someone who compares plans across companies, checks whether your doctors and prescriptions are actually covered, explains your options instead of pushing one, and stays reachable after you enroll — at no added cost to you.

The honest problem is that a surprising number of the people selling Medicare plans aren't set up to give you that.

I've been licensed for over 15 years.

In that time I've watched thousands of people shop for Medicare coverage, and I've also fielded a steady stream of calls from people who worked with someone else first — and got burned.

What Does a Medicare Insurance Agent Do?

A Medicare agent's job is to translate a confusing system into a plan that fits your specific situation.

A good Medicare agent should help you before, during, and after enrollment — not simply help you sign up for a plan.

In practice, that means:

• Comparing Medicare Advantage and Medicare Supplement plans available where you live
• Checking whether your current doctors and prescriptions are covered before you enroll, not after
• Explaining enrollment periods and deadlines so you don't miss a window or trigger a penalty
• Handling the actual paperwork and submission of your enrollment
• Coordinating your plan's effective date with your prior coverage — whether that's an individual plan or employer coverage — so there's no gap or overlap
• Explaining which documents you'll need to prove a guaranteed issue situation, since carriers won't process it without the right paperwork
• Reviewing your coverage each year, since plans and premiums change annually

One thing an agent can't do is enroll you in Original Medicare Part A and Part B directly — that has to go through Social Security or Medicare.gov.

A good agent will still tell you exactly where and how to do it, timed so your Part A and B effective date lines up with the start date of the plan you actually want.

That last point is where a lot of agents fall short.

Enrolling you in a plan is the easy part.

Sticking around for the annual review — when your plan's premium, network, or drug formulary may have changed — is where a good agent earns their keep.

Even if you don't end up changing plans, it's worth reviewing your coverage every year, since provider networks, formularies, and premiums can all shift from one year to the next.

Independent Agent vs. Captive Agent: What's the Difference?

This distinction matters more than most people realize when they're choosing who to work with.

Being independent doesn't automatically mean unbiased — an agent can still lean on the two or three carriers that pay the best commission.

But it does mean they're structurally able to shop the market for you, which a captive agent simply cannot do.

Do Medicare Brokers Cost You Extra?

This is one of the most common questions I get, and the answer surprises people: no.

Medicare agents and brokers are compensated directly by the insurance carrier, not by you.

Your premium is the same whether you enroll directly through the carrier, through Medicare.gov, or through a licensed agent — carriers set the same premium regardless of the enrollment channel.

Using a good agent to compare your options doesn't cost anything extra out of your pocket.

Medicare.gov vs. an Independent Agent

Medicare.gov's plan finder is a legitimate, free way to compare plans on your own.

The gap between it and a good independent agent is mostly in the follow-through:

Medicare.gov is a solid starting point for research. If you'd rather have someone check the details and stay available afterward, that's where a good agent adds real value — at no added cost to you.

Some people are perfectly comfortable researching plans on Medicare.gov and enrolling themselves, and there's nothing wrong with that approach if it works for you. Many others simply prefer having someone available to answer questions before and after enrollment — neither choice is the "right" one for everybody.

Who This Advice May Not Apply To

Most of this guide assumes you're still deciding whether — and who — to work with. That's not everyone.

• People who already know exactly which plan they want and just need to enroll
• Beneficiaries who prefer to enroll directly with Medicare or a carrier, without an agent involved at all
• Individuals who only want information from government resources like Medicare.gov or 1-800-MEDICARE

If that's you, the red flags and questions later in this guide are still useful for spotting bad advice elsewhere, but you may not need most of this guide at all — and that's a perfectly reasonable way to handle Medicare.

Finding the Right Broker

A few things tend to separate agents who run a real, sustainable practice from ones chasing a quick sale.

1. Experience

Look for an agent with at least five years in the business.

Medicare rules, carrier options, and enrollment timing all get more intuitive with time — an agent further into their career tends to move slower and ask better questions, rather than rushing toward a close.

2. Credentials

Can you find the agent online?

Do they use a professional email address tied to an agency, or a generic Gmail account?

What company or agency are they affiliated with?

None of these questions are disqualifying on their own, but an agent who's hard to find at all is worth a second look.

3. Client base

Ask roughly how many clients the agent works with annually.

An established practice usually means a track record of clients who stayed rather than churned.

4. Reviews

Look for reviews from actual past clients, whether on Google, an agency site, or elsewhere.

A pattern of reviews — good or concerning — tells you more than any single conversation will.

Watch for Broker Bias

Here's where I'd push back on how this topic usually gets discussed.

It's true that Medicare Advantage plans tend to pay agents differently than Medicare Supplement plans, and it's true that Medicare Advantage dominates the advertising you see every fall.

During the 2023 Annual Enrollment Period, KFF found that more than 85% of nearly 650,000 Medicare-related TV ad airings were for Medicare Advantage plans.

None of that means Medicare Advantage is a bad choice.

For a lot of people — especially those who are healthy, budget-conscious, and comfortable with a network — it's a genuinely good fit.

Medicare Supplement tends to make more sense for people who travel often, see specialists regularly, or want the flexibility of any doctor who accepts Medicare, without referrals or prior authorizations.

Timing matters here too — a good agent should also explain your guaranteed issue rights, since they affect when you can enroll in a Medigap plan without medical underwriting (see Medicare.gov's official guidance).

The problem isn't the plan type.

It's an agent who only shows you one of the two options and never mentions the other exists.

Before you enroll, it's worth asking a few questions the ad campaigns rarely address:

• Do I need referrals to see a specialist?
• Are my specific doctors in this plan's network this year?
• Are my prescriptions covered, and at what tier?
• How do prior authorizations work for this plan?
• Would a Medicare Supplement plan be worth comparing for my situation?

In my experience, an agent who's genuinely working for you will answer these without hesitation.

One who rushes past them is worth a second look.

Medicare Agent Red Flags Checklist

Our office fields a steady stream of calls from people who worked with another agent first.

Use this checklist during or after a conversation with any agent — checking more than one or two is a sign to look elsewhere.

It's worth being careful not to overgeneralize from any one bad experience — most agents aren't operating in bad faith, and CMS's own complaint data covers marketing practices across insurers, brokers, and third-party marketing organizations as a group, not agents specifically.

Still, CMS reported more than 41,000 complaints in 2021 about Medicare private plan marketing — more than double the prior year — which is a reasonable signal that oversight in this industry is inconsistent enough to warrant some caution on your part.

A Good Medicare Agent Should Ask You These Questions

Most guides only cover what to ask an agent.

Just as telling is what a good agent should be asking you.

If a conversation skips most of these, the recommendation that follows probably isn't personalized — it's just whatever the agent leads with by default.

• What medications do you currently take?
• Which doctors do you want to keep seeing?
• Do you travel frequently, or spend part of the year in another state?
• What's your monthly budget for premiums?
• Are you turning 65, or leaving employer coverage?
• Are you comfortable with prior authorization requirements?
• Have you already enrolled in Medicare Part B?

A good agent asks these before recommending anything.

If they skip straight to a plan, that's worth noticing.

10 Questions Every Medicare Agent Should Answer

Use this during your first conversation with any agent or broker.

A confident, direct answer to each is a good sign — hesitation, especially on the last few, is worth paying attention to.

What Happens After You Enroll?

Most people assume an agent's job ends once you're enrolled.

In reality, that's when the ongoing work begins — and it's the part almost nobody talks about.

• Annual Notice of Change (ANOC): every plan sends one each fall — a good agent reads it with you instead of leaving you to decode it alone
• Drug formulary updates: a medication covered this year can move to a higher tier, or drop off the formulary entirely, next year
• Network changes: doctors and hospitals can leave a plan's network between one year and the next, even if nothing else about your coverage changed
• Premium increases: both Medicare Advantage and Medicare Supplement premiums can change annually, and the cheapest plan this year isn't guaranteed to stay the cheapest

An agent who checks in on all four of these every year is doing the job completely.

One who only shows up at enrollment isn't.

Can You Change Medicare Agents?

Yes — but it's much harder in practice than people expect.

Once you've enrolled with a particular company through a specific agent, an outside agent generally can't do much to help you with that policy.

Most carriers won't go through the process of changing the agent of record, even if your original agent has disappeared.

This comes up often: someone has a Mutual of Omaha Plan G and wants to move to a High Deductible Plan G, also with Mutual of Omaha.

Because we're not the agent of record on that policy, our hands are tied — we can't make that change for them.

Their only options are to go directly to Mutual of Omaha themselves, or track down the original agent, who may not even be in the business anymore.

Our Process

We built our own process around the questions above, because we've seen firsthand what happens when they're skipped.

We start with your Medicare coverage start date, since that determines which enrollment periods apply to you.

From there, we ask about your benefit preferences, travel habits, budget, and any chronic conditions that might call for a more comprehensive plan.

We also walk through the differences between Original Medicare, Medicare Advantage, and Medicare Supplement, since most people have only ever heard about one of the three from advertising.

Why Trust Policy Guide?

Since we're asking you to hold agents to a standard, it's fair to show you where we stand against it.

Choosing Medicare coverage is a significant financial and healthcare decision, and every recommendation we make is based on your doctors, prescriptions, travel habits, budget, and coverage preferences — not on a single insurance company.

• Licensed Medicare insurance agency
• Licensed in Florida since 2003 — verify license
• Serving Medicare beneficiaries since 2011
• Licensed in 44 states — view all state license numbers
• 50,000+ Medicare beneficiaries assisted
• Annual plan reviews offered to every client, every year
• Licensed agents complete required CMS and carrier certifications each year

Learn more about how we're different →

Bottom Line

If you're new to Medicare or reconsidering your current plan, working with an agent is usually worth it — the coverage costs the same whether you go through an agent or not, and a good one saves you from mistakes that are expensive to fix later.

Before you commit to working with anyone, ask the ten questions above.

If they answer plainly and are willing to compare more than one type of plan, that's a strong signal you've found someone worth working with.

If you'd like help, we're happy to run a needs analysis and show you what's actually available in your county.

We'll compare every plan available in your county, explain why each one may or may not fit your situation based on your doctors, prescriptions, budget, and coverage preferences, and provide an annual review every year after you enroll.

Once you enroll, you'll have an ongoing service agent, so if you have questions in a month, a year, or six years from now, you can reach us.

Sources

• Commonwealth Fund — Role of Marketing in Medicare Beneficiaries' Coverage Choices (CMS complaint data)
• KFF — Medicare Open Enrollment TV Ad Analysis
• Medicare.gov — official U.S. government Medicare site
• Medicare.gov — Plan Annual Notice of Change (ANOC)
• Medicare.gov — Buying a Medigap Policy (guaranteed issue rights)
• Medicare.gov — Joining a Plan (enrollment periods)