Medicare Insurance Brokers: Be Cautious

As healthcare becomes more complex, especially for those transitioning to Medicare, the role of a knowledgeable and trustworthy Medicare broker becomes increasingly crucial.

However, not all brokers have your best interests in mind, and with so many options available, it can be tricky to find the right one.

We recently came across a study published by Fortune indicating that CMS received a staggering 41,000 complaints regarding Medicare insurance brokers, shedding light on the importance of choosing a broker wisely.

Understanding the Need for a Medicare Broker

Transitioning to Medicare can be overwhelming, with numerous plans, coverage options, and regulations. Many individuals are inundated with information and unsure of the best path forward. This is where a Medicare insurance agent can offer invaluable assistance.

A skilled broker can assess your unique needs, preferences, and budgetary constraints to help find the Medicare plan that suits you best.

The Importance of Expertise and Integrity

Our team at Policy Guide has witnessed firsthand the terrible consequences of working with inexperienced or unethical brokers during our 15+ years of experience helping Medicare beneficiaries.

We cannot stress enough the importance of having a knowledgeable broker in the Medicare field.

A note from the author:

“After 15 years in the Medicare industry, I’ve encountered many situations. It’s alarming how often clients recount being pushed toward Medicare Advantage plans without receiving information about Medicare Supplement plans. If all you hear from the broker has to do with Medicare Advantage only, then I would advise you to seek a second opinion because Medicare Advantage is NOT suitable for everyone, nor is it your only option.

Additionally, a frequent complaint is that many brokers disappear after helping with plan selection, leaving clients stranded when they require assistance. This is because they got paid and moved on.

Another emerging issue is that brokers neglect Medicare’s marketing regulations and engage in practices that violate the established rules.”

Mark Prip, founder of Policy Guide, Inc.

Beware of Medicare Broker Bias

Many Medicare brokers push Medicare Advantage, which is down right wrong!

Below are statements from a marketing analysis conducted by the Kaiser Family Foundation, which further highlights the bias of most Medicare brokers:

How Health Insurers and Brokers Are Marketing Medicare

-Kaiser Family Foundation


“TV ads for Medicare Advantage comprised more than 85% of all airings for the open enrollment period for 2023. The remaining ads focused on other types of plans, such as Medigap and stand-alone Part D prescription drug plans, or promoted the open enrollment period more generally. Medicare Advantage ads were disproportionately sponsored by health insurers who offer plans that comprise a relatively small share of Medicare Advantage enrollees.”


“The vast majority of Medicare Advantage ad airings touted low costs and extra benefits, while few mentioned quality ratings. Nearly all Medicare Advantage ad airings emphasized extra benefits, such as dental, vision, and hearing (92%) or the potential for lower out-of-pocket spending (85%). Airings sponsored by brokers and other third-party entities often (67%) promoted the potential for enrollees to get money back in their Social Security check (or lower their Medicare Part B premium). Few airings (4%) mentioned quality star ratings.”

Unfortunately, many brokers are biased and do not operate with the integrity and diligence necessary to serve their clients effectively. They can be driven primarily by sales quotas and commissions, leading them to prioritize their financial gain over your well-being.

Consequently, some Medicare brokers may recommend plans that are not the best fit for your circumstances or fail to disclose essential information about coverage limitations and out-of-pocket expenses.

Selecting the Right Broker: Key Considerations

Here are some important considerations when choosing a Medicare broker:

  • Experience:
    • Opt for a broker with five to ten years of experience for expertise and reliability.
  • Client base:
    • Ask about the number of clients the broker serves annually. A reputable broker will have a substantial client base, indicating ongoing client support.
  • Credentials:
    • Request the broker’s bio to find out their qualifications and Medicare background. Check their license details on the state insurance department website.
  • Reviews:
    • Seek feedback from previous clients. Positive reviews provide insights into the broker’s reputation and track record.

Working With Policy Guide - Our Process

1. The first factor we consider is your Medicare coverage start date, which determines your eligibility for open or special enrollment periods. This, in turn, affects the range of plan options available to you.

2. We’ll then work with you to determine your preferences and lifestyle, asking questions about your travel patterns, specialist referrals, and whether you prioritize cost savings or a comprehensive benefits package.

3. Once we have a clear picture of your needs, we’ll review your current healthcare providers and medications to ensure your selected plan covers everything you need.

4. We’ll also explain the differences between Original Medicare, Medicare Advantage, and Medicare Supplement plans to help you decide the best option.

Bottom Line

When it comes to choosing a Medicare broker, be sure to pick one with a proven track record of excellence and integrity.

Policy Guide prioritizes beneficiary education and support, recognizing the importance of personal details such as healthcare preferences, trusted physicians, and prescribed medications.

By conducting thorough fact-finding assessments, we make sure our clients have all the info they need to make healthcare decisions that work best for them.


  • What is a Medicare broker?

    A Medicare broker is a licensed professional who assists individuals in understanding and choosing Medicare plans that best fit their healthcare needs and financial situation.

  • Why do insurance agents push Medicare Advantage plans?

    Some brokers may prioritize their gains over recommending the best plans for clients.

  • How are Medicare agents paid?

    Medicare agents typically earn commissions from insurance companies based on policies sold. However, commission structures can vary depending on the insurance provider and specific plans. While commissions are standard practice, clients should be cautious of brokers driven by sales targets rather than providing impartial guidance.

Mark Prip

Since 2003, Mark Prip has been leading  Policy Guide, Inc., providing knowledgeable information about Medicare, life insurance, and dental coverage to clients in over forty states. With his unparalleled hands-on experience aiding countless Medicare beneficiaries in selecting an appropriate health plan, he is a prime example amongst other competitors for expertise and assistance. Mark has held his Florida Health & Life Insurance License (E051889) since 2003. View his license profile on the Florida Department of Insurance website.