Medicare Open Enrollment: How to Pick a Local Medicare Insurance Agent

Every fall the mailbox fills up with Medicare flyers, the TV fills up with ads, and the phone starts ringing with numbers you don't know. That's because Medicare's annual open enrollment period runs from October 15 to December 7, and changes you make then take effect on January 1. A good local Medicare insurance agent can make that season a lot calmer. A pushy one can talk you into a plan that doesn't fit your doctors or your prescriptions.

This guide covers what you can change during open enrollment, how agents work, and how to pick one you can trust. It's general information, not insurance or legal advice. For decisions about your own coverage, talk with a licensed agent or a free Medicare counselor in your state.

What you can change during Medicare open enrollment

During the annual open enrollment period, people with Medicare can generally:

• Switch from Original Medicare to a Medicare Advantage plan, or back again
• Switch from one Medicare Advantage plan to another
• Join, switch or drop a Part D prescription drug plan

Plans can change their costs, covered drugs and provider networks from one year to the next. Even if you were happy last year, it's worth checking that your doctors are still in network and your prescriptions are still covered at a price you can live with. Your current plan usually mails a notice in early fall explaining what's changing. Read it before you decide to stay put.

A quick word on the main options

• Original Medicare (Parts A and B) is run by the federal government. Many people pair it with a separate drug plan and a Medicare Supplement (also called Medigap) policy that helps with out-of-pocket costs.
• Medicare Advantage plans are offered by private insurers approved by Medicare. They bundle hospital and medical coverage, often include drug coverage, and usually work with a network of doctors.
• Part D plans cover prescription drugs.

Medigap works differently from the others. You can apply at other times of year, but outside your first Medigap enrollment window, insurers in many states can ask health questions and may charge more or turn you down. That's an important detail to ask an agent about before you drop a supplement.

How Medicare insurance agents work

Knowing how an agent gets paid and what they can sell tells you a lot about the advice you'll hear.

Captive vs. independent agents

• A captive agent works for one insurance company and can only offer that company's plans.
• An independent insurance agent or broker is appointed with several companies and can compare plans across them.

Neither is automatically better. But if an agent only shows you one company's plans, it's fair to ask whether better options exist elsewhere.

How they're paid

Medicare agents are usually paid by the insurance companies, not by you. That's why many say their help is free. It also means it's reasonable to ask how they're paid and whether that changes depending on which plan you choose.

They must be licensed

Agents need a state insurance license, and they're typically appointed with each company whose plans they sell. Your state's insurance department keeps a public lookup where you can confirm a license.

How to choose a Medicare insurance agent you can trust

Start local

A local agent knows which hospitals and doctor groups in your area work with which plans. That's often the single biggest factor in whether a plan works for you. On Listings Junkie you can browse insurance services by state, such as insurance agents in California, Florida or Texas.

A few examples of agencies listed on the site: Goulson Insurance Services in Los Angeles describes free, personalized guidance on Medicare, including Medicare Supplement coverage. Neldal Insurance Agency in Angleton, Texas, describes offering health coverage that includes Medicare supplements. Renee Brown Next Health and Medicare in Trinity, Florida, describes working with several insurance companies. These are examples, not recommendations, so check any agent's license and ask the questions below.

Bring the right information

A good agent will ask for these. If they don't, that's a warning sign.

• Your Medicare card
• A list of every prescription, with the dose and how often you take it
• The names of your doctors, specialists and preferred hospital
• Your pharmacy
• Any travel plans, such as spending winters in another state

Ask these questions

The last question matters more than people think. The best agents are there after the sale, when a claim gets denied or a pharmacy says a drug isn't covered.

Read reviews for the after-sale experience

Reviews that mention follow-up, patience and clear explanations are worth more than ones that just say "nice person." On Listings Junkie, customer reviews are confirmed by email before they show up.

Free Medicare help that isn't selling anything

You don't have to use an agent at all. Two free sources:

• Your State Health Insurance Assistance Program (SHIP) offers free, unbiased one-on-one Medicare counseling. Trained counselors don't sell plans.
• 1-800-MEDICARE and the official Medicare Plan Finder let you compare plans in your ZIP code yourself.

Many people use both: they compare on their own or with a SHIP counselor, then work with a local agent to enroll and for help later.

Red flags during open enrollment

• Calls you didn't ask for from someone claiming to be "from Medicare." Medicare generally doesn't call people out of the blue to sell plans.
• Requests for your Medicare number before you've confirmed who you're talking to.
• Pressure to decide today. You have until December 7.
• Promises of free gifts or cash for switching.
• An agent who won't check your doctors or prescriptions before recommending a plan.

If something feels off, hang up and call the number on your card or 1-800-MEDICARE directly. And if you're helping an aging parent with these choices, a trusted health and medical provider can often tell you which plans their office works with.

Frequently asked questions

When is Medicare open enrollment?

The annual open enrollment period runs from October 15 to December 7 each year. Changes you make take effect January 1.

Does it cost anything to use a Medicare insurance agent?

Usually not. Agents are typically paid by the insurance companies. Ask how they're paid so you understand any incentives.

What's the difference between Medicare Advantage and a Medicare Supplement?

Medicare Advantage replaces how you get your Original Medicare benefits through a private plan, usually with a network. A Medicare Supplement works alongside Original Medicare to help pay costs like deductibles and coinsurance. A licensed agent or SHIP counselor can explain which fits your situation.

What if I miss the December 7 deadline?

There are other enrollment periods for certain situations, and people already in a Medicare Advantage plan have a separate window early in the year to make some changes. Call 1-800-MEDICARE or your SHIP office to ask what applies to you.

How do I check that an agent is licensed?

Use your state insurance department's online license lookup. It's free and takes a minute.