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Icon - Medicare Agent & Agencies
Medicare Agents & Agencies

What Is a Medicare Agent?

by Ken Williams

UPDATED 13 SEP 2023 • ORIGINALLY PUBLISHED 17 MAY 2023

The entire Medicare system can be pretty confusing when you’re not familiar with the intricate details. Luckily, Medicare agents are experts on Medicare’s ins and outs and can help you figure out what’s best for you.  

A Medicare agent is a licensed professional who can help guide you through the various Medicare plans available to you. They are experts on plans and benefits and have the expertise necessary to answer all of your questions before making your healthcare insurance choice.

In this article, we introduce Medicare agents and what they can do to help you find the coverage that best meets your needs.

What Is the Difference Between Independent Agents and Captive Agents?

When searching for an agent, you will either work with an independent agent or a captive agent.

An independent agent works of their own accord and subsequently can work with a wide range of different insurance companies. They can help enroll you with any company they work with, which is great if you’re looking for more options or benefits.

A captive agent refers to an agent who only works with one insurance company. They have deep expertise into the ins and outs of every plan offered by the carrier for which they work and are a great choice if you already know that you want a plan from a specific insurer.  

How Do Agents Help? 

Medicare agents are experts across Medicare plans and benefits. Some of the services they can provide you with include: 

  • Understanding your coverage and benefits needs
  • Evaluating the options available to you
  • Understanding the different types of Medicare plans
  • Finding a plan that covers your doctors, pharmacies, and preferred hospitals

How Do Agents Get Paid?

When you work with a Medicare agent, you don’t have to pay them. Agents get paid by commission, which means that they receive a payment based on the enrollments that they secure. Moreover, they receive “renewal commissions” for future years that you stick with a plan or carrier, so there is a built-in incentive for them to find a plan that will meet your needs both today and in the longer term.

Some captive agents are also employed directly by insurance companies and are paid like regular employees.  

What Can (or Can’t) Agents Do?

A Medicare agent has to follow a stringent set of rules and regulations, which are in place to protect Medicare customers. 

An agent’s job is to educate potential Medicare customers on the plans and benefits they can receive from Medicare. This prohibits them from discussing outside products like life insurance, home insurance, annuities, and more.  

Medicare agents are also not allowed to ask for referrals, although they can leave you with sales material. They also cannot cold call, knock on your door, or appear at educational events.

Claire's Perspective

Claire’s Perspective

Medicare can be confusing, but you don’t have to do it alone! Whether you are new to Medicare and need to know how it works or whether you are looking to change your plan to ensure that your benefits continue to meet your needs, a license Medicare agent can help. Feel free to reach out to Ask Claire to learn more.

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