7 Places You Can Find Help with Medicare

If you are turning 65 or retiring and about to make your transition into Medicare, you're probably wondering where to go for help. The Medicare program can be extremely overwhelming at first, and you'll have important decisions to make. Fortunately, there is no shortage of information out there - you just have to take the time to devour it!

Today, we're going to give you seven places you can find help with Medicare. We'll tell you what to look for when perusing each option, and we'll even discuss the pros and cons of each.

Independent Agents and Brokers

An independent broker is someone who contracts with multiple insurance companies. They can offer you many options based on the coverage you're looking for and will be able to compare rates across companies. You don't pay any extra fees to work with a broker, nor do you pay higher premiums just because you used an agent.

Alright, confession time. Yes, we at Giardini Medicare are independent agents, and we might be just a little biased about the service we provide. BUT, there are some instances when we'll actually recommend you find other help! For example, we aren't experts at Medicaid, so we may need to refer those who qualify to other organizations. There are also a fair number of states that we aren't licensed in, so we can't help everybody.

Let's talk about what you should look for in an independent insurance agent. (Spoiler alert - we check all these boxes!)

Find a knowledgeable agent. This first one might seem obvious, but there's more to it than you might think. Here's what to look for.

• They specialize in Medicare. Any agent with a health insurance license can sell Medicare. But if it's not their full-time job, they probably don't have as much knowledge as other experts.
• They know the industry. Your agent doesn't have to have 30 years of experience, but it's certainly helpful if they have at least a few or if they have a supervisor who does.
• They know your market. Medicare Advantage and Part D prescription drug plans can be specific to your county, so it's important your agent knows the local area.

They offer both Medicare Advantage and Medigap (Medicare supplement) plans. If they only discuss one option, they're not giving you all the information and may have underlying reasons not to do so. A good broker will not pressure you into buying one product over another.

They take the time to learn about your situation. Nothing in Medicare is a one-size-fits-all solution. The agent should be able to direct you on how to apply for Parts A and B, how to file an IRMAA reduction (if you pay more than the standard Part B premium), and how Medicare works with both disability and Medicaid benefits. Plus, they should ask you about your budget and what kind of healthcare coverage is important to you.

Ask friends or trusted sources for referrals to a good independent agent. You can also look online for reviews based on your own research or your friends' recommendations.

Do you want an in-person agent or a virtual one? Neither option is wrong, but if you want someone you can meet with in person, make sure the agent you're considering can do that.

A Medicare broker should not cost you anything. You do not pay agents for their help, nor do you pay higher premiums because you've worked with one.

Lastly, an agent should offer year-round customer support. Agents benefit by keeping you as a client, so they should give you the customer service you need and make sure that they are there to answer your questions, help with billing issues and claims if and when those problems arise. At Giardini Medicare, we have a customer service team to help with all issues Medicare. At the end of the day, just being licensed and certified by something like AHIP (a Medicare industry test that agents must pass) doesn't mean much. Do your research!

So that we don't seem too biased, let's review the pros and cons of using an independent agent for your Medicare needs.

Pros

• Can provide an unbiased comparison of the Medicare plans available in your area.
• Can help you shop for plans in the future as your needs change.
• Will help you resolve any issues with your plans.
• Local agents know your specific market and programs associated with your plans.

Cons

• Not all agents have the same level of knowledge.
• Brokers may not work with all insurance carriers, including the one that might be right for you.
• They may not fully understand your local market offers.

Captive Agents

Captive agents work solely for one insurance company and can only offer plans and products from that specific company. Captive agents are typically direct employees of the carrier they represent. When you call an insurance company's 1-800 number, you'll likely be speaking with or directed to a captive agent.

If you've already decided on the Medicare plan you want, find out if it is offered only by captive agents. If so, seeking a captive agent is your only option. However, if you want more options, understand that a captive agent will only offer you their own solutions. They will not tell you to look elsewhere or give you information on how their plan compares to others.

Even if you know you want a specific product, as long as a broker can offer it, you are still likely better using the broker vs. the captive agent since they can compare other companies in the future. If your plan changes or rates increase, a captive company is not going to suggest you leave the plan.

Let's review the pros and cons of using a captive agent.

Pros

• They may offer a product you can't get anywhere else.
• They'll have extensive knowledge of the plans they do offer since there are few options.

Cons

• Their product is likely to be the only solution they offer, even if other Medicare plans on the market would fit your needs better.
• They won't compare future plans. Independent agents can shop for new plans yearly, but captive ones will not shop for other plans out in the general market.
• Their company may not offer additional plans you need, so you may have to seek an independent agent anyways.

State Health Insurance Assistance Program (SHIP)

You might also hear this referred to as the Area Agency on Aging. SHIP volunteers provide unbiased, helpful one-on-one counseling and assistance with your Medicare options. SHIP is an independent program funded by federal agencies.

Some insurance agents out there vilify SHIP counselors, but just like anything else we have talked about today, it all depends on the knowledge of the individual you speak with. Just remember, everyone in the world has biases regardless of whether or not they earn commissions.

Many SHIP counselors are volunteers, and that typically means that their knowledge can vary greatly. They do go through training, but it is simply not the same as spending every day for years solely devoted to helping people with their Medicare insurance.

If you are skeptical of a broker or someone that is receiving a commission, feel free to try both! You can talk to a SHIP counselor as well as a broker to see what you are comfortable with.

Pros

• It's free to have a consultation with SHIP.
• Can provide you with another set of eyes or a different perspective on your options.
• Can help you find financial assistance programs.

Cons

• Volunteer experience varies significantly.
• They are volunteers, not licensed agents.

Call Centers

Call centers can refer to a variety of operations. Small, independent agencies can perform telesales, and those are not the kind we're referring to. A call center, in the truest sense, is a large company that has hundreds of employees. They can be private or public companies and are usually the ones you see behind all the TV advertisements, especially in the fall.

Not all call centers are bad - it largely depends on who you talk to. Some of their agents have extensive knowledge, while others have limited information. Some work on commissions while others have hourly wages. However, if a call center tells you they work for Medicare, they are lying, and you should not speak with them.

If you decide to work with a call center, treat them like you would a local broker. Ask which plans they offer in your area and try to figure out how much they know about your local market.

Pros

• Phone appointments are convenient.

Cons

• You will probably never speak to the same agent twice.
• Agents will probably not know your local market as well as other agents since they work nationally.

1-800-Medicare

This is the phone number for the national Medicare program. Calling this number puts you in touch with phone representatives that work for the federal Medicare program. However, that doesn't mean these employees know more than anyone else. They are still call center employees who have as much (or as little) training as anyone else. Still, they are a good resource for finding out information about Medicare or if you have problems with your Medicare enrollment.

Contacting the government for help enrolling in Parts A and B is a good idea, but you should not rely on it to get your information about Medicare insurance products. Medicare.gov can also be a great resource for information without having to call their hotline. Calling Medicare is a good place to find out things like “does Medicare cover acupuncture?”. That can be looked up online or in their Medicare app for your smartphone. We just don’t recommend calling Medicare directly to enroll into your Medicare product.

Pros

• Can help with your Part A and B coverage.
• Can help with coordination issues once you're enrolled.

Cons

• Likely they'll only recommend Medicare Advantage.
• Limited knowledge with no ongoing support.

Personal Acquaintances and Referrals

If you don't know where to start, asking your friends, family, doctor, or other trusted advisor is a great idea. However, what you should not do is enroll in a plan just because someone you know has the same thing. What works for your friend may not work for you.

If you're speaking with a financial advisor, they may even offer Medicare products themselves. In some cases, this is OK, but make sure they have a team that specializes in Medicare and doesn't just "dabble" in it.

Pros

• You can get feedback about what they do or don't like about their choices.
• They may have a trusted broker to connect you to.

Cons

• They'll tell you to pick what they have, even though your needs are different.
• They may complain about an insurance company based on their opinions, even if the carrier did nothing wrong.
• Facts might be embellished to boast about their coverage.
• Doctors are great at treating you, but they don't all understand insurance.

Online Platforms

There is a crazy amount of information about Medicare online. You can search Google or YouTube, listen to podcasts, read articles, and find information on social media. We might sound like a broken record at this point, but the things you learn online might be great information, or they might be completely inaccurate. It just depends.

You should double-check any information you find online against what is written on Medicare.gov. If not there, at least verify the information from multiple sources.

Online sources are a great way to learn information about Medicare on your own timeline and at your own speed. You can learn about many topics and search for answers to specific questions. One word of caution. Do not put any of your contact information into online forms that you aren't sure of. You can call them directly instead. Giving away your contact information gives them the permission to call you and try to sell you products. (And we know you're already getting too many phone calls about Medicare..and your car's warranty!)

Pros

Great way to gather information without feeling pressured to buy.

Access is simple, quick, and you have a variety of options to consume it (read, listen, watch).

Cons

Anyone can post information on the internet. Lots of it could be inaccurate.

That wraps up our list of helpful resources! Any of them have the opportunity to be good or bad. It all boils down to the knowledge of the individual (or website) you're working with.

As we said in the beginning, we are independent Medicare brokers, so we always recommend you try to reach out to a broker with local knowledge and products to fit your needs. We do NOT work for the federal government or Medicare directly. We contract with insurance companies and get paid directly from them when we help you enroll in the Medicare coverage of your choice.