Why Medicare.gov Could Never Replace the Licensed Medicare Agent

In October 2019, Medicare redesigned their online Plan Finder tool claiming it was easier than ever to compare coverage options, shop for plans and help consumers feel more confident in their plan choices. They also enlarged the “Enroll” button so browsers wouldn’t have any problem navigating the site and promptly enrolling in a plan that offers the full array of services desired. 

So, what’s the problem then?

Comparing a side by side plan grid of doctor visit copays and hospital services is the final piece of the Medicare enrollment puzzle and is not fundamental to the Medicare learning process that leads you to choosing a plan.

For example, Plan Finder starts out by asking you a few quick questions. It wants to know if you want more information on either a Medicare Advantage Plan, a Medigap Policy (what’s that you ask), or a Part D Drug Plan. This question alone could send the average person into a downward spiral.

The fact is that there is no government website or entity including Medicare or Social Security that will readily provide all the answers to your pre-enrollment questions. If you have ever called either of these agencies, then you already understand that nobody on the other side of that telephone is cheerfully helping you navigate through thousands of benefit rules.

Contrary to the two agencies mentioned above, a Licensed Medicare agent completes an extensive amount of annual training that goes above and beyond obtaining and retaining a state license.

Not to gloat, but Medicare annual training is a rigorous and time-consuming process for any agent who offers multiple plans (a broker) and includes 80+ hours of courses each year. There is a day long federal test that must first be completed prior to certification courses attached to every plan we offer. In comparison to our annual training requirements and according to the U.S. Bureau of Labor Statistics, the most popular disciplines for certificate training programs are affiliated with healthcare practitioners…plus it keeps us really smart!

Why don’t you offer every plan available at Medicare.gov?

Well, we try. Every year new plans appear in each county and sometimes they stick around a year or two and then disappear. From time to time they stick, so then we certify to sell them. The problem with new plans is that we don’t have any data such as Star Ratings to judge their performance. They also tend to come in with the strongest benefits that fade over the next several months, and we term these ones unsustainable because that’s exactly what they are. Please don’t judge us for being cautious, but we would rather ride on the side of caution when we are offering plans that cover your risk.

What extra services can a Licensed Medicare Agent offer?

Lots, without ever charging a fee. We are paid a flat commission by the Centers for Medicare & Medicaid Services (CMS) to advise and help you enroll.  Using an agent doesn’t cost a penny more than self-enrolling online and you have access to a professional, so you don’t make any mistakes.

Our expert knowledge includes:

  • Networks – There are 40 Medicare Advantage Plans in San Diego County and each plan has its own unique network of providers. Let us help you assure you stay attached to your doctors.
  • Other Coverage Considerations – We can help you understand how Medicare works with COBRA, FEHB, Employer Sponsored Coverage, Covered CA, Veterans Benefits, Tricare or a Retiree Plan.
  • Delaying Medicare Part B or Part D – Let us help you understand when you can delay without penalties and explain how late enrollment penalties apply.
  • Travel Considerations – Maybe you have dual residence or just take occasional trips overseas, but either way we can advise how each plan would offer coverage for those travels.
  • Prescription Drugs – Learn what a formulary is and how we can help you enroll in the plan that covers your unique prescription drug needs at the lowest possible cost.
  • Costs – Medicare is not free. It is important to know that Medicare Part A and Medicare Part B may have premiums each month. There may also be extra premiums to enroll in a Medicare Advantage Plan, Medicare Supplemental Policy or Part D Prescription Drug Plan. We can explain your fixed and variable costs.

So, there you have it. You can either read the 2020 publication of “Medicare & You” to learn how to do this on your own (if you need to cure insomnia), or you can connect yourself with a professional Licensed Medicare Agent who can guide you. When you support and Agent, you also support a small business owner.

Thank you