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Michael T Braden April 24, 2024 BRADEN MEDICARE INSURANCE
WHY WORKING WITH A LICENSED, INDEPENDENT, MEDICARE BROKER IS IMPORTANT
Yes, it makes just plain old good, common sense to work with a Llicensed, independent Medicare broker. They can explain things in an easy-to-understand manner, after all, we all know Medicare is confusing as all get out. You get to lean on a broker's years of experience and knowledge, and it does not cost you a single penny.
Did you know that the average Medicare Agent works for only 1 or maybe two Medicare Insurance companies? Most Independent Medicare Brokers average 7-10 Companies and at Braden Medicare we are contracted with more than 35 of the top Medicare Insurance companies in America!
If you decide to partner with anlicensed, independent Medicare Broker helps to speed up the Medicare process by guiding you through the process more quickly and efficiently than you could possibly do on your own. A Medicare Insurance broker has more coverage and plan options making it easier for them to assist you with finding the right plan that meets all of your needs. your broker will guide you through the paperwork process and find a plan that meets your budget for price and the plan that best meets your needs and the desires of your loved ones. Honestly, there is no way you can learn in a few weeks or months what an experienced Medicare Broker has learned over 5-10 years or more.
FAST FACTS
The prices of Medicare Insurance plans are finalized by each State. Therefore, no one can quote you a better rate than anyone else. But, brokers can offer more plans, have more knowledge of discounts and at the end of the day, you will save more by working with an Independent Medicare Broker.
Medicare Insurance Brokers are licensed professionals who help individuals navigate Medicare options, ensuring they enroll in plans that suit their healthcare needs and financial situation, adhering to stringent regulations.
Medicare Brokers earn their income from commissions set by state insurance authorities or the Federal Government, depending on the plan.
An independent Medicare insurance broker places the clients’ interests before commission differences between plan options. A good broker does not even know what his/her commission rates are, they are truly focused on meeting and exceeding the expectations of their clients.
Independent Medicare Brokers prioritize education about Medicare options, conduct thorough plan comparisons in benefits and costs, and offer ongoing support post-sale to ensure clients’ needs continue to be met.
Medicare Supplement policies typically pay twice the commissions of a Medicare Supplement plan.
WHAT MAKES AN MEDICARE AGENT A MEDICARE BROKER? AREN’T THEY ALL THE SAME?
They are not the same, when you work with an independent, licensed Medicare Broker, you get the best of teh best. You are in control, but you have access to multiple plans frm multiple carriers. By law, a Medicare agent can only discuss plans they are licensed with.
Understanding Medicare insurance becomes simpler when you have an experienced guide to assist you. Medicare Insurance Brokers are licensed professionals who simplify the Medicare landscape for individuals.
Listening to what the client wants out of their Healthcare plan.
Assisting clients in evaluating, selecting, and enrolling in a plan
Addressing inquiries from their clients.
Answering questions and easily explaining the benefits and or shortfalls of any Medicare plan under consideration.
Assist their clients in selecting the right Medicare plan, including Medicare Advantage and Medicare supplement plans.
A Medicare Insurance Broker, also known as a Medicare Broker or Medicare Agent, undergoes extensive training on Medicare law and Medicaid services and is officially certified by insurance companies by CMS guidelines. They are required to adhere to stringent regulations, particularly about marketing and enrollment, ensuring full compliance with Medicare, state insurance regulations, and private insurance companies.
YOUR 3 OPTIONS FOR MEDICARE COVERAGE
OPTION 1
Medicare in its purest form is what is known as Original Medicare. Original Medicare comprises Medicare Part A (In-Patient & hospitalization costs and Services) and Medicare Part B (all of your Outpatient costs and services such as doctors, Office Visits, Labs, Diagnostics, Screenings, Procedures, and Durable Medical Equipment).
Original Medicare is a straightforward 80/20 Plan where Medicare pays 80% of all Medicare-approved (Medically Necessary) procedures and you are responsible for your 20%. There is no Deductible (Aside from the annual $226.00 Part B Deductible), No Minimums, and no Maximums. Plus, there is a $1,632 Part A Deductible if you’re admitted into a hospital (Each 60 days). With Original Medicare you can see any Doctor and use any Physician anywhere in the United States because there are no networks. (Only about 1% Of People Choose This Option)
OPTION 2
Original Medicare with a Medicare Supplement or Medigap plan. A Medicare Supplement can pay for all of your 20% share of all of your Healthcare, depending on which Medicare Supplement Plan you choose. Plan G is the most popular and has the best Value. It runs between $120-$150 per month. This is still an 80/20 plan, but aside from your premium, you would only have to pay the Annual Part B Deductible of $226.00 out of pocket, everything else, including the Part A Deductible, will be paid by Medicare, and your Medicare Supplement plan.
Altogether the best estimate for the best coverage with no hidden costs would be around $320 per month and include absolutely everything, with no deductibles (aside from the $240 Annual Part B Deductible), no co-pays, no co-insurance, no additional deductibles to meet. And you can see any doctor or receive services at any hospital in the United States. With a Medicare Supplement Plan G, your maximum Annual Out-Of-Pocket Expense will be your Medicare Supplement /Medigap plan premium and the Annual Part B Deductible of $240. About 6 out of 10 people choose this plan.
OPTION 3
A Medicare Advantage, often referred to as Medicare Part C. These are plans offered by a private for-profit Medicare Insurance company. These companies receive money from Medicare, and these companies manage their plans. You will either choose an HMO (Health Maintenance Organization) or a PPO (Preferred Provider Organization) Plan. An HMO plan typically will include a Part D Prescription Drug Plan, but you will have to see their network of doctors and hospitals. This means you have little or no coverage outside of the city or out of the state.
A Medicare Advantage PPO plan will have more options for doctors who are outside of the plan's network. However, most Medicare Advantage PPO plans do not include any Part D. The majority of MA (Medicare Advantage) HMO plans have a $0 premium. A MA/PPO plan will range from $0 to $100 depending on where you live. With every Medicare Advantage Plan, you pay your 20% throughout the year. There is an annual maximum that varies by plan, they range from $2,800 - $5,900 annually in network and up to $12,000 a year if you go out of network. Once you meet the MOOP (Maximum Out-Of-Pocket) amounts for a given year, your plan pays 100% of the charges for the remainder of that Calendar year.
This means that if you run into bad luck, you could pay up to the amount of your Maximum out-of-pocket expense every year. About 4 in 10 Choose Medicare Advantage.
Everyone who chooses Medicare Advantage must pick a new plan each year during the Medicare Annual Enrollment Period. They can keep their current plan if it is still available, or they can choose a new plan that will start on January 1st.
MEDICARE ADVANTAGE = MEDICARE PART C
When you see or listen to Medicare Advantage Plans on the Television or Radio, you may recall hearing something about Medicare Part C. And Medicare Part C is just another phrase for Medicare Advantage plans.
This traces back to the early 1990s when President William Jefferson Clinton signed Medicare Part C into law. At that time, Medicare Part C was referred to as Medicare Choice! Medicare Part C plans, aka Medicare Advantage plans give the consumers the option to choose Original Medicare, and purchase a Medicare Supplement or to enroll in a Medicare Advantage plan.
For those of you old enough to remember the old Midas Commercials, where they state “You can pay me now, or pay me later”, that is a pretty good description of Original Medicare vs Medicare Advantage (Medicare Part C). You see if you have Original Medicare and a Medicare Supplement, you pay a monthly premium each month in addition to the $174.70 that every Medicare Beneficiary pays for Part B each month. In return, your only other out-of-pocket expense will be your $240 Annual Part B Deductible. So, you pay now, but you pay nothing later. With a Medicare Advantage Plan, you typically have a $0 – low monthly premium, but you pay Co-Insurance and Co-Pays for Services throughout the year. Most Medicare Beneficiaries will spend $2,000 - $3,000 on average every year on their Healthcare. And, much more if there is Surgery or a Cancer Diagnosis.
Medicare Advantage plans are an alternative to Original Medicare that can offer additional benefits and often include prescription drug coverage. Many Medicare Advantage Plans provide extra benefits that may include some of the following:
Vision care
Hearing care
Fitness programs
Dental care
Medically necessary transportation
Prescription drug coverage
They can coordinate with other types of insurance to cover expenses and offer a comprehensive range of plan benefits.
WHAT ARE MEDICARE SUPPLEMENT PLANS?
You might question, ‘What about the costs Original Medicare doesn’t cover?’ Here, Medicare supplements, or Medigap policies, play a role. Medigap plans provide coverage for expenses that are not covered by Parts A and B of Original Medicare, such as deductibles, co-pays, and coinsurance. A Medigap policy can set a limit on your financial exposure to Medicare bills.
The best time to buy a Medigap policy is during the six-month enrollment period that begins on the first day of the month in which you turn 65 or older and are enrolled in Medicare Part B. The key here is that your Medigap initial enrollment period starts the day your Medicare Part B coverage starts.
During your Medigap initial enrollment period, you can buy a Medigap policy with no health questions or preexisting conditions.
MEDICARE INITIAL ENROLLMENT PERIOD CHART
INDEPENDENT VS. CAPTIVE AGENTS
The choice between an independent Medicare agent and a captured agent is as significant as selecting the appropriate Medicare plan. Independent agents represent multiple insurance companies, offering a wide array of options. This makes them informed advisors who can provide education and guidance in comparing plans, costs, and benefits.
The independent agent represents your best interest.
On the other hand, captured Medicare agents:
Work exclusively for one insurance company.
Can only offer products specified by the insurance company they work for.
May be limited to the offerings of a single insurance company, as opposed to different insurance companies.
Captured agents tend to be new agents. Working for an insurance company is how many agents get started in this business.
HOW DO MEDICARE BROKERS GET PAID?
You might wonder how these brokers make a living. They earn their keep through commissions from insurance companies, rates set and regulated by state insurance authorities or Medicare itself. The commission rates can vary depending on factors such as the type of plan and the membership status of the enrollee.
Typically, Medicare insurance brokers may earn the following commissions:
$500-$700 for every new Medicare Advantage plan they sell
$300-$400 for annual renewals of Medicare Advantage plans
Up to $100 per sale of Medicare Part D plans if you are new to Medicare.
$50 for each renewal of Medicare Part D plans
The commission rate can differ from state to state, but the renewal commission generally remains consistent at approximately 10 percent of the plan’s premium.
Medicare agents earn higher commissions from selling Medicare Advantage plans compared to Medigap (Medicare Supplement) plans.
With a Medicare supplement, the agent typically earns between 20% and 30% of the monthly premium for a fixed period set by the state. Most states limit the payment to six years.
A good Medicare broker should first show you the Medigap plans available to you. This is because Medigap coverage is greater than Advantage plan coverage. Only if there are no Medigap plans that meet your needs and budget should you then explore Medicare Advantage plan options.
HOW TO INTERVIEW A MEDICARE BROKER
Health Insurance is important, and it is perhaps never more important than when you first apply for Medicare coverage. Making the wrong decision, or not being properly informed of both your options and the possible repercussions of your options is critical.
We believe working with an Independent Medicare Broker is the best option for every Medicare beneficiary. We also think there are some important things you can do to protect yourself and also to determine who would be an excellent Broker for you and your family to work with.
Brokers should be patient, kind, respectful, educated, and have excellent communication skills. And, for the way I was raised, they should come across as being genuine, helpful, humble, and kind.
Here are a few other things I believe every Medicare beneficiary should do when considering a Medicare Broker:
Call and speak with 2-3 Local Brokers. Just type in Medicare Brokers Close To Me or Local Medicare Brokers into the Google or Bing Search Box. Then call them, introduce yourself, and ask them to relay to you what they do as a broker.
Why did they decide to become a Broker in the first place? This will tell you if they are chasing a paycheck or if they are truly a service-oriented individual.
What is the best part of their job? How long have they been brokers? Most creditable brokers will have a minimum of 3 years of experience.
Ask them for their website address and their email address. Any professional Broker will have a full website, not just a one or two-page landing page. They should also have a professional email, for example, our website is www.bradenmedicare.com and mike@bradenmedicare.com is the email address that I use for my business.
Ask them what percentage of their clients have Medicare Advantage Plans and How many have Medicare Supplements.
Ask them how many companies they represent. Most Brokers will be contracted with 5-7 Companies, some will have more, and I have yet to meet many that have over 25, For the record, we are contracted with over 36 Insurance companies.
Lastly, and I think this will give you the best perspective of who you are speaking with, ask them to just take a few minutes and give you a brief explanation of what your options are with Medicare. You can tell if they are comfortable being put on the spot, if they are personable, genuine, or if they are stuffy and full of themselves.
WHAT YOU SHOULD EXPECT FROM A MEDICARE BROKER
Engaging an independent Medicare Broker comes with specific expectations. A Medicare Broker should prioritize education, guiding you through the complexities of Medicare options before suggesting specific plans. They should first review Medicare supplement options, taking into consideration benefits and costs, to assist you in making well-informed decisions.
If a supplement is not in your budget, they should evaluate Medicare Advantage plan options, conducting a comprehensive comparison of benefits and costs to assist you in selecting the most suitable plan for your specific needs.
LISTENING TO YOU IS THE FIRST STEP FOR ANY REPUTABLE BROKER
A Medicare Broker should listen to you and ask you about what you want in a Healthcare Plan. They should ask you about your lifestyle, do you like to travel and do you plan on traveling during retirement.
How do you feel about using strict Networks of Providers to receive care?
Have you had in the past or are you presently dealing with any Health issues?
They may ask you about your family and what type of Insurance your family would want you to have.
They should inquire about any plans you have to get any lingering Health ailments taken care of.
Lastly, they should ask you to not just determine what you want your Healthcare plan to provide for you today but also ask you what you want your Healthcare plan to cover 5, 10, or 15 years from now.
EDUCATING YOU ON MEDICARE & EXPLAINING YOUR OPTIONS
Education forms the foundation of the broker-client relationship. A proficient Medicare broker will provide comprehensive explanations of the various Medicare plan options, such as Medicare Advantage and Medicare Supplement plans, ensuring a thorough understanding of the available options to facilitate informed decision-making regarding healthcare coverage.
To comprehend your specific coverage needs, a Medicare broker may inquire about various aspects such as:
Changes to your current plan.
Availability of new benefits.
Inclusion of prescription drug coverage.
Coverage for your prescriptions.
Length of time enrolled in your current policy.
Any chronic conditions.
Prescription drug usage and costs.
Availability of in-network access to your providers.
REVIEWING THE COSTS AND BENEFITS OF MEDIGAP PLANS (aka MEDICARE SUPPLEMENT PLANS)
Reviewing and comparing Medicare supplement options is Medicare insurance agents' crucial responsibility. Medicare insurance agents should provide a comprehensive analysis of the benefits and costs of different Medigap plans. This analysis should cover details such as co-payments, deductibles, and premiums, allowing you to understand the financial implications of each plan.
Remember, each Medicare supplement offers a unique set of benefits and coverage options. The broker should guide you through these options, helping you understand how they can meet your healthcare needs and financial situation with Medicare supplement insurance.
A COMPLETE REVIEW AND ASSESSMENT OF MEDICARE ADVANTAGE COSTS AND BENEFITS
Likewise, your broker should thoroughly review Medicare Advantage Plans. This should include a comprehensive comparison of benefits and costs, allowing you to make an informed decision about which plan is right for you.
The broker should also explain the differences in coverage between Medicare Advantage Plans and Original Medicare. Understanding these differences is crucial for you to make an informed decision about your healthcare coverage.
SHOULD I FIND A BROKER CLOSE TO ME, OR DOES IT NOT MATTER?
It is difficult to find a Medicare expert broker who offers all the insurance products available in your area. Most of the time, the local agent has limited experience.
You should seek out the best broker available to help you with your needs. In this day and age, the best agents are always just a phone call away.
DOES THE BROKER-CLIENT RELATIONSHIP END AFTER I HAVE MY POLICY?
Your interaction with your Medicare agent extends beyond the purchase. A reliable Medicare agent should continue to provide support and assistance even after the sale. This includes offering answers to queries, assistance in identifying an appropriate plan, and furnishing information about the Medicare process.
Your Medicare agents can assist with:
Changes in Medicare coverage
Resolution of issues
Navigating through various plans
Assist you and your family in any Healthcare-related enrollments in the future. Such as Dental, Vision, Life, Long-Term Care (LTC), or Final Expense Insurance.
Handling post-sale issues such as Medicare appeals and objections.
Most Medicare Brokers will gladly help you with anything you ask them. A question about coverage, a possible procedure you are considering, talking with their friends or relatives about Medicare.
Any broker worth their salt will be there for you and your family forever.
SHOULD YOU WORK WITH A MEDICARE BROKER?
It depends on your situation whether you should use a Medicare broker, but many people seeking Medicare plans find their guidance helpful. Consider your individual needs and the complexity of the process. Sometimes, it just makes sense to work with someone who is an expert, that can explain your options and then you make the final decision. It is a lot less confusing and easier to comprehend Medicare when you work with someone who is an expert in the Medicare space.
WHAT IS THE POINT OF WORKING WITH A BROKER?
The point of an insurance broker is to help you save money by comparing policies, tailoring coverage to your needs, avoiding mistakes, and representing you to find the best option. They act as an intermediary between you and the insurance company, providing expertise and guidance.
ARE THERE REAL DISADVANTAGES TO HAVING A MEDICARE ADVANTAGE PLAN?
The disadvantages of Medicare Advantage plans include restrictive networks, high out-of-pocket costs, prior authorization requirements, and annual plan changes. It’s important to carefully consider your current and future needs when evaluating your Medicare insurance options.
WILL A BROKER TELL ME WHAT PLAN TO CHOOSE?
I hope not. The role of a Broker is to Teach, Educate, and present options so that based on their experience and expertise, show you the plans that best fit you, and your lifestyle and match your wants, needs, and desires. The Broker’s role is to gather, organize, and present the information/findings to you. It is then ultimately your decision to choose the plan you believe is best aligned with your wishes and goals.
WRAPPING THINGS UP
To sum up, understanding the role of a Medicare Insurance Broker is crucial in navigating the complex world of Medicare insurance and the various insurance products. They serve as your guide, helping you understand the different types of Medicare plans, including Medicare Advantage and Medicare Supplement plans. They can assist in evaluating, selecting, and enrolling in a plan that suits your healthcare needs and fits your financial situation.
Whether you choose an independent agent or a captured agent, a local broker, or an online one, the key is to find a professional who keeps your best interest at heart. They should provide education, offer guidance, review different plan options, and continue to support you even after the sale. With their help, you can make informed decisions and find the right Medicare plan for you.