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Enrolling in Medicare is a decision that can provide you with health, hospital, and prescription drug insurance coverage. Let’s discuss some aspects of Medicare and determine if it’s the right option for you.
Enrolling in Medicare doesn’t have to be complicated or stressful. There are many options available, so our team is here to assist with the enrollment process. If you have any questions or would like to begin enrollment today, make an appointment to speak with one of our professionals.
Medicare is health insurance. It is administered by the government and enrollment can be done through Social Security. In order to qualify for Medicare, you typically must reach a certain age. Those who have paid into Medicare taxes for the required amount of time will be able to enroll and will not be required to pay the Part A premium.
There are two different areas of Medicare that must be understood…
All of these questions are going to get anybody's head spinning.
Medicare is a national health insurance program that is set up for most individuals that are 65 and older. I say that because there are some exceptions for those of us under 65, and that would include individuals who are on disability or have terminal illnesses.
For most individuals, when they turn that magic age at 65 - that's when they go into
Medicare a full time. When you're about 64 and a half-ish you will start to get lots of Medicare information and mail, as well as some probably unwanted calls. But for most, turning 65, that's when you go on Medicare. There are some of you who turn 65 and continue to work past 65 and are on your employer insurance and that's okay once you fully retire that's when you will go on to Medicare full-time.
What are the parts of Medicare and how many parts are there?
There are four main parts to Medicare with an optional fifth part that I will go into later.
The parts up of A,B, C, and you guessed it: Part D.
Part A is your hospital insurance, and this helps cover your hospital care. Most individuals get this automatically when they age into Medicare, and it's usually at no additional cost to you.
Part B is your medical insurance and that includes things such as doctor's visits, outpatient procedures, lab work, and various things like that.
Part C is also known as a “Medicare Advantage Plan.” In order to get Part C you have to have Parts A and B, that is the requirement. These Medicare Advantage plans typically have additional benefits that Parts A and B don't cover, which are things such as dental and vision.
Part D - I like to call it “Part D for Drugs,” because it's an optional prescription drug plan that you can either purchase separately, or a lot of times you can get it built into your Part C Medicare Advantage plan.
So those are the four main parts of Medicare.
That optional fifth part that I was talking about is a Medicare supplement or a Medigap plan, and these plans are basically the “bee's knees.” They basically help work side by side with the original Medicare, and they help cover the costs that Parts A and B do not cover.
I get a lot of questions of “Do I need Part D?”, especially from those individuals who are really healthy and are not taking any prescriptions. And there are two main reasons why I suggest that you do get a prescription drug plan when you go into Medicare.
First reason is you incur a late enrollment penalty when you finally do enroll in a prescription drug plan. So, if you wait a couple years and then you change your mind and say “Yeah, I think it's time for me to go on a drug plan”, so that amount of time that you went with that one you will be paying a penalty, and it's not a one-time penalty. So to spare you from having to do that I recommend getting a prescription drug plan when you finally go into Medicare.
But the second reason - and in some cases the more important reason - is because we don't have a crystal ball and we cannot predict what our health is going to be like in the future years to come. Most people tend to not get healthier as we get older. So if you decided to skip on getting a prescription drug plan, and then at some point during the year something happens and now you are taking prescriptions and you don't have any coverage at all, you can be incurring hundreds and hundreds of dollars in prescription drug costs that you shouldn't have to pay if you had a prescription drug plan.
So I always recommend that you get a Part D drug plan, whether you purchase it separately and get a Medicare supplement or you get it built into your Medicare Advantage plan. Very important to have that!
I hope all this information was helpful! If you have any other questions, feel free to give us a call at 888-959-1028, or check out our website https://myhealthcaredirect.com.
Medicare is a service administered through Social Security. It provides exceptional insurance coverage and can reduce medical bills. Those who have another form of health insurance can still enroll in Medicare, meaning that coverage can be maximized and benefits are used comprehensively.
Original Medicare consists of Parts A and B. It is a basic level of health insurance and many prefer it because of lowered bills. However, there is no flexibility offered through Original Medicare. If you are enrolled in Original Medicare, you may purchase a Medigap policy. If you do want to be able to make changes to your coverage, consider Medicare Advantage.
Part C, or Medicare Advantage, allows the beneficiary to establish which areas of coverage will be included in their policy. While all Part C policies include Original Medicare coverage as a baseline, there are many other options that can be added on. If you choose Medicare Advantage, you will not be able to enroll in Medigap.
Medicare is an excellent option for health insurance during retirement. It can greatly reduce financial responsibilities and lower medical bills. If you have questions about enrollment or would like to begin the process today, contact us to learn more.
Medicare eligibility primarily depends on the age and tax status of the individual. There are some situations in which exceptions to these eligibility requirements are acknowledged, but those situations are not as common.
The typical enrollment age for Medicare is 65. This is when the individual’s Initial Enrollment Period will begin and they can make any changes to their Medicare policy. Around this time, beneficiaries will be mailed a packet that will detail their policy and new coverage.
Exceptions to the age requirement are made on the basis of diagnosis. Those with specific diagnoses can enroll in Medicare before their 65th birthday.
Tax history is the second important eligibility requirement that must be met in order to be eligible for Medicare. If you or your spouse has paid into Medicare taxes, you’ll most likely be eligible for premium-free Part A.
If you don’t qualify for Medicare because of your tax history, you may still be able to purchase Medicare.
Hi, i'm Jessica Manion at My Healthcare Direct, and I'm going to be going over what it means to be Medicare eligible, as well as some important information regarding what you're enrolling in, as well as some important information regarding enrollment periods that you should be aware of.
So, typically to become Medicare eligible, you're put into one of two groups:
The first group is those of you who are either turning 65, or those of you who are retiring that are older than 65 and will be going on to Medicare full-time.
The other group is those of you who are under 65 but you've been on social security disability for at least 24 months or two years. Typically, at that point is when most people become Medicare eligible.
So, when you become Medicare eligible, there's two things that you typically enroll in.
The first is Part A, which is your hospitalization coverage. For most people - or their spouse - who have worked for 10 years paying into Medicare through their taxes, you get Part A completely free. So, in most cases, most people get Part A for free.
The second thing you're enrolling in is not free: Part B, which is your outpatient coverage, such as doctor's visits, outpatient surgeries as well as blood work, MRIs, things like that. You do have a monthly premium, and in this year 2021, that premium is 148.50 UDS/month. For most individuals who are on social security already, they will deduct that from your social security check.
Once you become Medicare eligible, regardless of if you're in group one or group two, there's a couple of important enrollment periods that you should know about:
The first is called your IEP or Initial Enrollment Period, and this really affects those of you that are turning 65. You have a seven month window to enroll in a Medicare plan, whether that's staying with original Medicare and purchasing a separate Medicare supplement and prescription drug policy, or if you enroll in a Medicare Advantage plan. That seven month window starts three months before the month you were born in, includes the month you were born in, and three months after.
So, if you were born May 20th, your Initial Enrollment Period would begin in February. Then you would have February, March, and April, May the month of your birthday, and you will also have the three months after, so June, July, and August. So, from February to August, you have that time where you can enroll in a Medicare plan.
The second enrollment period to know is the Special Enrollment Period. This typically happens when you're already on Medicare, and it'll be a qualification that you'd have to meet in order to change a plan. For those of you especially on a Medicare advantage plan and, say you move from one state to another, you typically are able to enroll in a separate Medicare advantage plan that is available in the new area that you moved to. So, you want to make sure to keep an eye on, especially if you're on an Advantage Plan, that if you move that you need to make sure that you have a plan that is servicing your area.
Another enrollment period that you want to be aware of is the Open Enrollment Period, which is not to be confused with the Under-65 Open Enrollment Period that goes on in the Fall. So, the Medicare Open Enrollment Period begins on January 1st and lasts until March 31st. So, during this time, if you're on a Medicare Advantage plan, you can go ahead and switch to a different Medicare Advantage plan, or you can go back to original Medicare and purchase a prescription drug plan.
Last but certainly not least is the AEP or the Annual Election Period. Anybody on Medicare will definitely recognize these dates I'm about to tell you, because you will see tons of commercials on your tv during this time of year. From October 15th to December 7th, that is your opportunity to make a change, regardless of whether it's a prescription drug plan, a Medicare supplement, which really you could do at any time of the year, or your Medicare Advantage plan to take effect in January 1st. That is probably one of the important enrollment periods that you're going to want to remember once you are Medicare eligible.
So, for those of you who are turning 65 or you're already older than 65 but you're going onto Medicare full-time, meaning enrolling in Part B, you can purchase a Medicare supplement plan without any health questions or underwriting. I like to call this the “Golden Ticket to Willy Wonka's Chocolate Factory”: You're going to be automatically approved for your supplement.
Once you're past that enrollment window - so if you're turning 65, that's that seven month window where you can actually almost enroll up to six months before your birth month, you will automatically be approved and you won't have to go through underwriting. However if you are past that window, then you will have to answer health questions.
So it's very important to know if you're first going onto Medicare, especially Part B, you will be guaranteed to get on a Medicare supplement with no health questions asked. And finally if you want to enroll in a Medicare Part D prescription drug plan, you must be enrolled in Part A and/or Part B in order to be eligible for a prescription drug plan.
Questions?
If you have any other questions about whether you are Medicare eligible or have any other questions about enrollment periods or what plan you should go with once you are Medicare
eligible, feel free to give our office a call at 888-959-1028. You can also find us on Facebook.
The costs associated with Medicare can depend on a variety of factors. Whether you have Original Medicare or Medicare Advantage, the length of hospital stays, prescription drugs, and other things can impact how much your Medicare policy will cost you. Let’s break down some of the individual costs and discuss what policies they’re associated with.
Medicare deductibles are paid annually. Once the individual has paid their deductible, Medicare will cover most, if not all, of the remaining medical costs. Being knowledgeable of your plan’s deductible is important when making decisions and can greatly impact how much you’ll need to pay.
Premiums are paid monthly. They’re the cost required to keep your Medicare plan and can change based on your income. Most people are eligible to receive Part A premium-free.
Coinsurance determines how much you’ll still need to pay after you’ve reached your deductible. It is typical to pay 20% of Part B costs once your deductible has been met.
For 2026, the Part A inpatient hospital deductible will increase from $1,676 in 2025 to $1,736, a $60 increase.
Daily hospital coinsurance costs are also rising. For days 61 through 90, coinsurance will increase from $419 per day in 2025 to $434 per day in 2026. For lifetime reserve days, coinsurance will increase from $838 to $868 per day.
The skilled nursing facility coinsurance will also increase next year, going from $209.50 per day in 2025 to $217 per day in 2026.
For individuals who do not have enough work credits to receive Part A at no cost, monthly premiums will also increase. If you have 30–39 quarters of coverage, your Part A premium will be $311 per month in 2026, up $26 from $285 in 2025. If you have fewer than 30 quarters of coverage, your Part A premium will increase to $565 per month, a $47 increase from $518 in 2025.
Now let’s move on to Medicare Part B, which covers medical and outpatient services.
In 2026, the standard Part B monthly premium will increase from $185 to $202.90, a $17.90 monthly increase, or approximately 9.7% compared to 2025.
The Part B annual deductible will also increase, rising from $257 in 2025 to $283 in 2026, a $26 increase, or about 10.1% for the year.
Some higher-income Medicare beneficiaries may be subject to IRMAA, which stands for Income-Related Monthly Adjustment Amount. Individuals subject to IRMAA pay higher Part B premiums and may also pay an additional Part D IRMAA.
IRMAA is determined based on your modified adjusted gross income from two years prior, meaning 2026 IRMAA amounts are based on your 2024 tax return, regardless of whether you file as single, married jointly, or married separately.
For 2026, individuals who are single or married filing separately with income under $109,000, or married filing jointly with income under $218,000, will continue to pay the standard Part B premium. If your income exceeds those thresholds, your adjusted Part B premium and Part D IRMAA amounts will apply as shown.
While Medicare does have some costs, they are worth it. Having health insurance can relieve stress, financial responsibilities, and medical bills. Being insured is an important part of planning for the future and being prepared for various situations.
If you’re wondering whether enrolling in Medicare is right for you, our professionals can answer your questions. Being aware of the costs of Medicare is important when selecting a plan, so we’re here to discuss your options.
Some people will need to apply, while others will be automatically enrolled. If you do need to apply for Medicare there are three ways to do it.
Enrolling in Medicare is done through Social Security. There are three ways to apply:
Applying can be done over the phone, using their website, or at one of their offices in person. Each option will have the same result, so choose the one that’s most convenient for you.
Medicare Advantage is sold through private insurance companies. If you’re looking to enroll in Part C, research the providers in your area and the policies that they offer. You should always work with an insurance provider that you trust.
If you’re ready to apply for Medicare, our team at My Healthcare Direct can walk you through the process. Applying with the help of a professional will ensure that your forms have been filled out correctly and your application materials are in order. Call us at (888) 959-1028 to make an appointment.
Do you have Medicare & employer coverage and are wondering how that could impact your Medicare coverage? Let’s discuss your options and how to maximize the benefits you have available to you.
Hi, I'm Jessica Manion at My Healthcare Direct, and in this video I'm going to be going over Medicare and employer coverage - how it works and what options you have if you continue to work past 65.
The biggest thing to know if you're turning 65 and you have group health coverage is the size of your employer, because that's going to help determine whether or not you go on just Medicare Part A, which is your hospitalization coverage, or if you're going to want to go on Medicare Part A and B.
20 or more employees
If your employer has 20 or more employees, your employer's insurance is going to be primary and Medicare is going to be secondary. Because of this most people tend to just enroll in Medicare Part A, which for most people will be free, and they delay their Part B and their Part D.
When it comes time to retire, most people qualify for what's called an SEP or a Special Election Period, where you then can enroll in Part B and Part D, and the best part is that for most people, you will not face that late enrollment penalty for Part B and Part D.
If your employer has less than 20 employees, then the opposite is going to be true: Medicare is going to be your primary health insurance, and your employer's insurance will be secondary. Because of this, most people tend to enroll in both, Part A and Part B. There is a premium for Part B, so if you decided not to take your Part B and pay that 148.50 a month, what's going to happen is: Whenever you eventually do enroll in Part B and go on Medicare full-time, you will have that late enrollment penalty that you will have to pay.
So, if you're someone who's still continuing to work and you know that your company has less than 20 employees, you may want to consider enrolling in both Part A and Part B.
Any further questions?
If you have any other further questions about your employer coverage versus Medicare, feel free to give our office a call at 888-959-1028. You can also like us on Facebook.
It is entirely possible to be enrolled in both Medicare and the insurance you receive from your employer. This is an excellent option that can have lots of benefits. One policy may pick up where the other leaves off, giving you increased benefits and access to more coverage.
If you’re still receiving employer coverage during your Initial Enrollment Period and decide to not enroll in Medicare yet, you may be granted a Special Enrollment Period. This would allow you to enroll in Medicare past your Initial Enrollment Period, without incurring any extra fees.
While insurance can provide important medical coverage, it also comes with its own costs. If you’re wondering whether two insurance policies are worth it, our professionals at My Healthcare Direct can answer your questions.
Dental, vision, and hearing coverage is not typically included within Original Medicare.
There are some situations when some coverage might be extended, however. For example, if you are having jaw surgery and dental work results, Medicare might cover it.
Whether or not Original Medicare coverage will be applied to a situation depends on each individual circumstances. If you use dental, vision, or hearing services, you’ll be required to pay for these fully out-of-pocket.
Medicare Advantage, or Part C, is an excellent option if you wish to add coverage to your policy. Dental, vision, and hearing coverage can all be added, meaning that the coverage options with Part C extend beyond what Parts A and B offer.
If you’re considering Medicare Advantage, ask yourself a few questions:
If you want to have control over your insurance coverage and be able to formulate a policy that will fit all your needs, consider enrolling in Medicare Advantage. If you’re wondering what options you have available, make an appointment to discuss that with one of our professionals. We look forward to hearing from you!
If you are eligible to enroll in Medicare before 65, you’ll still have all the same benefits available to those who meet the standard age requirement. People under 65 who are eligible for Social Security disability benefits or Railroad Retirement Board benefits can also get Medicare.
Do you have disabilities?
Medicare is available for individuals under the age of 65 with many different disabilities.
If you or a family member has a qualifying medical diagnosis, you can enroll in Medicare under 65. Let’s take a look at what medical conditions qualify.
Qualifying diagnoses include:
If you are eligible for early enrollment, contact My Healthcare Direct to learn more.
Medicare has four parts:
Medicare Part A is hospital insurance that helps pay for inpatient care in a hospital or skilled nursing facility. It also covers some home health care and hospice care.
When you are on disability or under 65 and qualify for Part A Medicare or Premium-Free Part A, you don’t have to pay a premium. Most people automatically get Part A coverage if they’re eligible for Medicare under 65. You can also get Part A coverage if you buy it.
Medicare Part B is a type of Medicare insurance that helps cover medical expenses for those under 65. It can support the cost of outpatient treatment, doctor visits, and other healthcare services. This plan also covers some preventive services to help keep you healthy.
If you have Medicare Part A, you’re automatically enrolled in Part B. If you don’t have Part A, you can enroll in Part B during your Initial Enrollment Period.
Medicare Advantage Part C is a type of insurance offered by private insurance companies that contract with Medicare to provide coverage to Medicare beneficiaries under 65. This type of coverage usually includes all of the benefits that Original Medicare (Parts A and B) covers and a Medicare Advantage Prescription Drug Plan (MA-PD).
Medicare Advantage plans usually have lower premiums than traditional Medicare plans, but they also have higher out-of-pocket costs. This means that you will likely pay more for your health care, but you will have a lower monthly premium.
If you are under the age of 65 and interested in signing up for a Medicare Advantage Plan, you can contact My Healthcare Direct to learn more about this type of insurance. We will compare plans in your area and help you choose the right one for your needs.
Part D Medicare drug plan coverage is a federal program that helps seniors and Medicare beneficiaries under 65 pay for prescription drugs. The program is run by the Centers for Medicare & Medicaid Services (CMS) and is available through My Healthcare Direct.
Part D plans help people afford their brand-name and generic drugs. Because of this, it’s often called the Medicare Coverage Gap Discount Program. CMS requires all Part D plans to offer a standard benefits package that includes coverage for at least two drugs.
Most prescription drug plans (PDP) have a deductible, and then beneficiaries pay a coinsurance or copayment for their prescriptions. Some plans also offer coverage for drugs that are not covered by Medicare Part B, such as those used for long-term care such as cancer or AIDS.
Learn more about the Medicare benefits available to you. When you speak with a My Healthcare Direct representative, we can help you find the best Medicare plan for you.
If you meet the requirements to enroll in Medicare, we will get you started! Once you are enrolled, you will be mailed your Medicare card.
Medicare makes decisions on a case-by-case basis. Figuring out if you qualify for Medicare under age 65 can be complicated at times. If you are under 65 and you have a qualifying condition or are disabled, Medicare may be available to you.
Our professionals are here to assist in the process.
Make an appointment today to speak with our team about the insurance options available to you.
Medicare makes decisions on a case-by-case basis. Figuring out if you qualify for this health insurance can be complicated at times, so our professionals are here to assist in the process. You can make an appointment today to speak with our team about the insurance options available to you.
Medicare covers a large variety of benefits and services depending on the plan(s) you purchase. Benefits vary between Parts A, B, C (Advantage), D, and supplements.
Original Medicare (Parts A and B) offer low-cost, basic, and very necessary coverage. Part A covers short-term, emergency nursing home and hospital stays:
Part B covers a huge variety of various medical benefits, including anything that is Medicare-approved and deemed “medically necessary” by your doctor. This can include benefits such as:
Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare. As long as you’re eligible for both Part A and Part B, you can choose to enroll in Part C instead. No matter what, all Part C plans will include all of the same coverage as Original Medicare, as well as potentially Part D and some limited dental, vision, and hearing coverage.
Medicare Advantage functions on a network of healthcare providers. Within this network, your out-of-pocket costs are reduced. Each Advantage plan’s coverage will look a bit different, but they all work based on this principle. There are 5 different types of plans:
Part D covers virtually any and all prescription drugs. The amount you pay, however, depends on the plan and type of prescription. Prices and coverage are categorized into 5 different tiers, each tier with different required out-of-pocket costs call coinsurance or copayment fees:
Medicare supplements are an additional-coverage plan that can literally “supplement” your Original Medicare plan. They cover a vast amount of extra benefits. There are 10 different plans—A, B, C, D, F, G, K, L, M, and N. Of these plans, Plan F covers the most—any of the other 9 will have some variation of these benefits:
The typical enrollment age for Medicare is 65. Those with a qualifying diagnosis may be able to enroll in Medicare before that age. If you’re wondering whether or not you qualify for Medicare, reach out to our professionals today at 941-773-9953 or use our contact form. We look forward to hearing from you and discussing your insurance options.
If you have a disability, you more than likely qualify for Medicare, even under age 65. You qualify after receiving 24 months of Social Security benefits, ALS (Amyotrophic Lateral Sclerosis), or End-Stage Renal Disease (ESRD).
Anyone under age 65 who has received Social Security disability insurance for at least 24 months should be eligible for Medicare. When this required amount of time has passed, you will receive a letter in the mail informing you of your next options.
When you are enrolled, you cannot be denied coverage based on the type of care you need, even for conditions such as:
Eligible benefits are determined on a case-by-case basis—so, you will never be turned down because of the condition you have. Rather, specific care coverage will be determined as you need it. You will never be denied if you need care for an extended amount of time, or because they are considered “maintenance only” issues.
You are also automatically eligible for Medicare regardless of age if you have ALS (Amyotrophic Lateral Sclerosis) or End-Stage Renal Disease (ESRD).
People with disabilities who are eligible for Medicare receive all of the same coverage as regular Medicare beneficiaries. Under Part A, this includes:
Generally, then, Part A includes hospitalization coverage. Part B, on the other hand, covers general medical services and supplies—anything that is eligible for coverage that is deemed “medically necessary” by your doctor. This can include things like:
You will more than likely be automatically enrolled into Parts A and B when you reach the required 24 months. You can, however, choose to also enroll in a Part D plan, or a separate Part C plan instead.
Most Part C plans include Part D coverage but, if not, you can add one. Or, you can not get Part C, and simply add a Part D plan to Original Medicare.
You can receive continued, long-term Medicare based on your disability until you turn 65. At that time, you will simply no longer be covered as a disability, but as a regular beneficiary, but your benefits will not change.
However, many people with a disability choose to return to work at some point. With regards to your Medicare coverage, there are 3 different ways in which your coverage will end/continue:
Having a disability does not mean that you deserve less Medicare help than others. At My Healthcare Direct, we have worked with people just like you since day one and will be here as long as you need. Call today at (888) 959-1028.
The role of a Medicare agent is to talk over your options, evaluate your current coverage, stay up-to-date on Medicare, and to save you time, money, and trouble.
There is a huge difference between the captive and non-captive insurance agent—captive agents are tied to very few companies and products, and they will only try to sell you on their specific offerings. Non-captive agents, on the other hand, can objectively consider the entire scope of healthcare options to find a plan that truly serves you best.
The non-captive agent, then, will discuss all of your options and stick with you overtime to make sure you keep receiving the best service.
Because agents stay with you over the duration of your plan, you can go to them for any questions regarding your coverage. Say, for instance, you’re concerned about increasing premiums—you can call your agent, and simply ask how much your premium will increase (if at all) the following year.
You will also have to renew your coverage on an annual basis, which your agent will gladly take care of. Not only that, but non-captive agents can also search the market for potential other plans for you to enroll in instead of your current plan. Agents earn a similar commission for both new enrollments and renewals, so you know that, when they suggest a new plan, it’s because they truly feel it will benefit you in some way.
Because Medicare is a federal program, it is subject to changes in the law, court rulings, etc. For instance, your Part A and Part B premiums and deductibles are subject to increase by a few dollars each year. Your agent will keep track of this and will let you know so that you are up-to-date.
Specific rules regarding Medicare Advantage, Part D, and supplements are subject to change as well, both on a federal and insurance company level. Agents can help you understand what this means for you, how it will affect you and can help find you a different plan if you no longer want the same coverage.
In the grand scheme of things, Medicare agents in Florida or anywhere in the U.S. are dependable, informed, and well-versed in the Medicare market. There are so many options for coverage—Original Medicare, 10 different supplements, 5 different Advantage plans, and a plethora of Part D plans—how can you know which is best for you, let alone find and compare plans in your area?
This is why agents are so incredibly beneficial to Medicare beneficiaries—they save you time, money, and trouble trying to figure things out on your own.
My Healthcare Direct is a completely independent agency, with non-captive agents waiting to help people just like you. We’re real people with a real sense of the Medicare world and, with our expertise, we will find a plan that will work best for you, and stick with you to make sure you keep receiving the best coverage. Give us a call today at (888) 959-1028.
Medicare agents are paid by commission for new sign-ups and renewals, but customers do not directly pay for their agent’s commission. It is better to choose a non-captive agent.
When a Medicare agent has a customer, they receive a commission. This is the main way in which they earn their money. In 2021, the maximum commission amounts are $539 for a new Medicare Advantage plan with drug coverage and $81 for a new Part D plan. This, however, is the maximum—not all states and regions provide this full amount.
Agents also receive a commission when their customers renew their plans. In 2021, the renewal commission maximums set by the Center of Medicare Services (CMS) are $270 for Medicare Advantage plans with drug coverage enrollments and $41 for Part D enrollments.
Supplement plan commissions vary greatly between providers because they are not as heavily regulated by the CMS. However, the typical commission is between 15% to 26% of the annual deductible.
These renewals are actually very beneficial to the consumer as well as the agent. Because agents are reliant on you to come back to them for renewal, they will stay up-to-date on your coverage and make sure all of your needs are taken care of, so that you are satisfied and come back. Not only that but because agents receive a very similar payment for a new enrollee, you know that if they are recommending you to a new plan, they truly want to help you, not just make money.
Don’t worry, however—when you buy a plan, you are not paying for this commission. Your price will fall under the same government standard no matter what. The insurance company as a whole pays this commission.
There are 2 main categories of agents—the “captive” and “non-captive” agent. Captive agents are tied to one specific insurance company, provider, and plan. So, when you work with them, they will be working very hard to sell you on their one specific plan rather than searching the entire market of availability.
The non-captive agent, on the other hand, is independent from any specific insurance plan. Typically, they work with an equally independent agency that searches for plans throughout the market. When you get advice or buy a plan from one of these agents, then, you know you are getting an unbiased, real perspective on what works best for you.
When you’re choosing an agent, then, look for a non-captive agency. There is no real way to consider the agent’s commission rate in your decision, but just know that, as long as they’re non-captive, you can count on them to give you unbiased help and continued guidance throughout your time with them and the plan.
My Healthcare Direct is a 100% independent agency, with access to a wide range of companies and products, unbiased and objective advice, advocacy, and consistency. To work with our reliable team, give us a call today at (888) 959-1028.
