A health insurance broker is a go-between – between you and the insurance company whose policy you choose. If you know the insurance company you want to work with, you can call the company directly, and they will route you to an agent who will work with you.
But if you are buying this type of insurance for the first time or have run into claims or billing issues before, a broker who has access to multiple companies could be your best option.
This broker could be a traditional (offline) broker or an online go-between, which includes e-brokers and marketplaces. Here we’ll focus on traditional brokers.
Buying Medicare insurance is not “one and done.” With Original Medicare, your Parts A and B do not change. But you may want to change add-on prescription drug plans or supplement (Medigap) plans.
With Medicare Advantage, you will have to renew your plan each year. And changes to your plan’s approved doctors or prescription drug plan medications can lead to a policy change.
Having the right broker for Medicare can make or break your retirement, whether you choose Original Medicare or a Medicare Advantage plan. So how do you make sure you have the right person?
1. Are they licensed? A broker needs to pass the state licensing exam and obtain a license to market Medicare plans. If licensing information isn’t on their website or forms, ask them for it in writing, maybe as an email.
Action: Most state Department of Insurance websites let you confirm if the person’s license is active and see if any disciplinary action has ever been taken against them.
2. What experience do they have selling Medicare plans in your state? Regulations differ state-to-state on what plans can be offered and how prices can be increased. Therefore, you want someone who is an expert in your state.
Action: Ask for their professional history working in your state. Check the issue dates on licenses as confirmation.
3. Are there any broker costs involved? The insurance company covers the cost of a broker helping you to buy a policy. But if the broker is going to manage your policy over time, that may not be free.
Action: Ask if there are any extra fees for services and get a fee schedule in writing. You will have to include any fees in your budget.
4. What can you expect as customer service? You only discover how good a service provider is when you have a problem to solve. But you’ll want the reassurance of direct access to your broker. Whether that person is part of a small business or a larger brokerage, you want to know that one specific person will oversee your account – someone who knows you and your needs.
Action: Check for online ratings, reviews and testimonials. Some brokers may be accredited by the Better Business Bureau, so check there, too. If you didn’t find the broker through a reliable reference, ask for the name of an existing client you can call.
5. Do you like the person? Facing health insurance issues can make you feel vulnerable, especially if you’re sick. You want someone who is fighting for you, not someone who is cold, disinterested or unreachable.
Action: What does your gut tell you? Can you share your real healthcare needs comfortably? And is the person listening? Do they even care? If you feel any discomfort, move on and find another broker before making your final decision.