What Is a Medicare Advisor?

Medicare advisors are insurance agents, Medicare brokers and Medicare underwriters. They work for private companies that are under contract with Medicare to sell certain Medicare plans — Medicare Advantage plans and Medicare Part D prescription drug plans.

Many insurance agents may sell insurance plans besides Medicare. Other advisors may specialize in Medicare plans.

You should look for a Medicare advisor who offers a variety of plans from different providers. Medicare advisors should be unbiased and weigh the pros and cons of various Medicare plans as they apply to your personal situation.

You should shop around and compare Medicare advisors to find one who is well versed in the intricacies of Medicare coverage and who can give you a clear understanding of how each plan he or she sells addresses your specific needs.

Medicare brokers and agents can be very similar as both can help you identify and enroll in a Medicare plan.

The main difference is that a broker typically does not have a relationship with one firm and can help you compare plans from different providers. This isn’t always the case with an agent.

If your agent is captive, then that means they work exclusively for certain insurance companies and typically must direct you to their specific plans. But there are also independent agents who can help you identify and enroll in any plan, regardless of provider.

Medicare underwriters essentially work to assess the risk that an insurance company is taking on by accepting you as a beneficiary. The underwriter may do research and ask you questions to get an idea of your current health situation.

If you are already dealing with serious health problems or are very likely to be in the near future, the underwriting process may determine that you are not a fit candidate to be a beneficiary and you may not be accepted onto the plan.

You often don’t pay Medicare advisors anything for their services. Your only costs will be actually enrolling in the plan after your agent or broker helps you find and select it.

Medicare Advisors are typically paid by commission, meaning they earn money from the insurer once you have signed on to become a beneficiary.

It’s important to understand how your Medicare advisor is paid since it could play a role in the options presented to you. For example, if you have a captive agent as your advisor, they may not receive a commission if you select a plan that is not from the firm or firms they are connected to.

Before looking for a Medicare advisor, you should first compare plans. You can use Medicare’s plan finder tool do this.

You can then contact companies or Medicare advisors that sell these Medicare plans. To find them, you can search the internet for “Medicare advisors near me.” Or you can go through professional agent associations in your state.

Once you have a list of plans and potential Medicare advisors, you can begin narrowing your options.

You may want to consider an agent or broker who specializes in Medicare plans. A specialist may have more expertise and skill in helping you find the best plan for you.

You should also remember to consider whether the advisor is a captive agent or an independent agent. This can make a difference in getting the best plan for you.

You should also make sure your Medicare advisor is licensed in your state and has passed an annual American Health Insurance Plans (AHIP) exam.

AHIP is a trade association of health insurance professionals. Medicare advisors should be AHIP certified and hold other certifications for the particular types of Medicare plans they sell.

A Medicare advisor must get your permission to meet in person and cannot come to your home without an appointment.

If you make an appointment at your home or in the advisor’s office, the Medicare advisor must document the plan options you wish to discuss.

You have certain rights when meeting with a Medicare advisor. There are certain things an advisor is not allowed to do during your appointment.

If your Medicare Advisor fails to follow these rules you should immediately notify Medicare by calling 1-800-633-4227 (TTY users can call 1-877-486-2048).

You can find free Medicare counseling and assistance through your local State Health Insurance Assistance Programs (SHIP).

SHIP provides unbiased, one-on-one counseling for anyone who is eligible for Medicare as well as their families and caregivers.

SHIP counselors can explain complex issues involving your Medicare coverage including coverage changes, Medicare costs, enrollment questions, what your Medicare covers and how to appeal claims.