Turning 65? Why Having the Right Medicare Agent Matters—Now and for Years to Come

ANSWER FIRST: An independent Medicare agent compares plans from multiple carriers and stays with you in the years after you enroll. Agents are paid by the insurance companies, so there is no cost to you. The difference matters most later — when a premium rises, a plan changes, or your prescriptions change.

Turning 65 comes with a lot of Medicare decisions.

You may be getting mail every day. You may be seeing Medicare commercials on television. Your phone may be ringing. And if you have searched for Medicare information online, you may suddenly feel like everyone wants to sell you something.

So it is understandable to wonder: Do I really need a Medicare agent?

We believe the better question is: if you can have an experienced Medicare professional helping you understand your options, why would you want to figure everything out alone?

And choosing your initial coverage is only the beginning. A good Medicare agent should be someone you can call this year, next year, after a premium increase, when your prescriptions change, or whenever you have questions about your coverage.

How Do Medicare Agents Get Paid?

This surprises many people.

Medicare agents and brokers may receive compensation from insurance companies when they help eligible beneficiaries enroll in certain Medicare plans. CMS publishes Medicare Advantage and Part D agent/broker compensation information and regulates how those agents and brokers are compensated.

In other words, using an agent does not mean you should automatically assume you are getting a higher plan premium simply because an agent helped you.

That makes the more important question: who do you want helping you make these decisions? Someone whose goal is simply completing an enrollment, or someone you can build a relationship with and call again when you need help?

Be Careful Who You Give Your Medicare Information To

Large Medicare call centers are not automatically bad. But before enrolling through one, ask some questions.

• Will I be able to call this same person next year?
• Will this person help me after the sale?
• Will someone review my coverage with me again?
• What plans and insurance companies can this agent discuss with me?
• If I have a Medicare Supplement underwriting problem three years from now, will I know who to call?

Those questions matter.

At MedSuppUSA by Central States Insurance, our goal is not simply to help you get through your 65th birthday. We want to be your Medicare resource for years to come.

Your Medicare Coverage Should Not Go on Autopilot

One of the biggest Medicare mistakes is choosing coverage at 65 and never looking at it again. Different types of Medicare coverage need to be reviewed differently.

Medicare Advantage and Part D: Review Them Every AEP

If you have a Medicare Advantage (MA/MAPD) plan or a standalone Part D prescription drug plan, we recommend reviewing your coverage every Annual Enrollment Period (AEP). Medicare Open Enrollment runs from October 15 through December 7 each year.

Why review annually? Because your plan can change. Your Annual Notice of Change explains changes in things such as your plan coverage and costs for the following year. Medicare recommends reviewing those changes to determine whether the plan will continue meeting your needs.

Your prescriptions can change too. The plan that worked great for you this year may still be the right plan next year. But do not assume it is. Review it.

Medicare Supplements Work Differently

This is where Medicare Supplement coverage gets interesting.

A Medicare Supplement does not have an annual enrollment period like Medicare Advantage or Part D.

Your initial Medigap Open Enrollment Period is generally the six-month period that begins when you are 65 or older and enrolled in Medicare Part B. During that protected period, an insurance company cannot deny you a Medigap policy because of pre-existing health problems.

After that period, however, things can be different. You may be able to apply for another Medicare Supplement during the year, but depending on your circumstances and state rules, the new insurance company may use medical underwriting to determine whether it will accept your application.

That is very different from thinking, "I have to wait until AEP to look at my Medicare Supplement." AEP is primarily about Medicare Advantage and prescription drug coverage. You do not necessarily have to wait until October to investigate whether another Medicare Supplement may be available to you.

Do Not Be Afraid of Medicare Supplement Underwriting

The word underwriting scares some people. It should not automatically stop you from asking about your options. That is my job.

Before we submit an application, I can review your health history, medications and circumstances and look at the underwriting requirements of the Medicare Supplement companies available to us.

And this is an area where experience matters. Not every insurance company asks its health questions exactly the same way. One company may have a health condition that creates a problem while another company underwriting guidelines may treat that situation differently.

There can also be look-back periods. For example, a carrier may ask whether you were diagnosed with or treated for a particular condition within a specified number of months or years. That means something that prevented you from qualifying previously may not necessarily prevent you from qualifying forever.

Were You Turned Down Before? Do Not Automatically Give Up.

This is particularly important. Someone may tell us, "I tried changing Medicare Supplements two years ago and got declined."

My response is: let us look at it again.

A previous decline does not automatically tell us what another carrier will decide today. Your health may have changed. Your medications may have changed. Enough time may have passed to get beyond a carrier look-back period. Or another insurance company may have different underwriting questions or requirements.

There are never guarantees with medical underwriting, and the insurance carrier ultimately makes the eligibility decision. But "I was declined before" does not mean you should never investigate your options again.

You can read more in our guide on whether you can be turned down for a Medicare Supplement plan.

This Is Why Medicare Supplement Underwriting Experience Matters

Shopping Medicare Supplements is not simply about finding the lowest number on a rate sheet. We need to determine whether changing coverage makes sense and whether you can qualify for the new policy before making a change.

Medicare itself cautions that outside your Medigap Open Enrollment Period or certain guaranteed-issue situations, you may not have a federal right to switch policies.

That is why I do not recommend cancelling an existing Medicare Supplement just because we find a lower rate. First, we investigate. We review the situation. We determine which carriers may be worth considering. We apply when appropriate. And we make sure the new coverage is approved and the effective dates are handled correctly before making changes to existing coverage.

How Often Should You Review Your Medicare Supplement?

There is not a Medicare rule saying you have to shop your Supplement every three years. But as a practical rule, I recommend talking with your agent at least every few years, or sooner if you receive a substantial premium increase.

Why? Because Medicare Supplement premiums can change over time. And because Medigap plans are standardized, when you are comparing the same lettered plan, you are comparing the same basic standardized benefits even though different insurance companies may charge different premiums. Medicare specifically recommends comparing the same lettered plan when shopping among insurers.

For example, if you have Plan G, it may be worth periodically investigating what other Plan G options are available. That does not mean you should change. Sometimes staying exactly where you are is the best recommendation. But you will know because we reviewed it, not because nobody ever looked.

See also: how often should you review your Medicare Supplement plan and why Medicare Supplement rates increase.

The Medicare Relationship Should Not End When You Turn 65

This is probably the most important thing we want people to understand. When you work with us, we are not looking at your 65th birthday as the finish line. It is the beginning of the relationship.

We want you to call us when:

• You are turning 65 and do not know where to start.
• Your prescriptions change.
• You receive your Medicare Advantage or Part D Annual Notice of Change.
• A Medicare Supplement premium increases.
• You are wondering whether another Supplement company might accept you.
• You have previously been declined for a Medicare Supplement.
• You simply do not understand something Medicare sent you.

You should not have to start over with a stranger every time you have a Medicare question.

Turning 65? Start With Someone You Can Call at 66, 70 and Beyond.

Choosing Medicare coverage is an important decision. But choosing who helps you with Medicare can be just as important.

At MedSuppUSA by Central States Insurance, we help people understand their Medicare choices and remain available after enrollment.

If you are approaching 65, we would be happy to help you get started. And if you have had Medicare for years, it is never a bad time to ask whether your coverage deserves another look.

Call us at 785-342-2684 or contact us through MedSuppUSA.com.

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