A Medicare Advantage Agent is someone who can help you select and enroll in a Medicare Advantage, Part D, or Medigap supplemental plan that best meets your needs. They will spend time with you, gain a clear understanding of your health needs and finances, and then offer you plans that fit within those established parameters. They can also help you annually review your plan and change it if necessary.

Many people rely on brokers and agents to help them choose coverage because they have extensive knowledge of the insurance market and how various plans work together. These individuals are also able to explain the ins and outs of the Medicare program and the rules and regulations that govern it. They may even be able to help you avoid common mistakes that can lead to costly penalties or delays in receiving your benefits.

However, beneficiaries often lack information about how brokers and agents winnow down plan options for their clients and the role that financial incentives might play in this process. To understand this better, the Commonwealth Fund partnered with PerryUndem to conduct four focus groups of brokers and agents who sell Medicare Advantage plans, Part D prescription drug plans, and Medicare Supplement Medigap coverage.

One key finding from the focus groups is that many brokers and agents earn extra income by conducting beneficiary health risk assessments during the Medicare Advantage plan selection process. These surveys are intended to gauge a beneficiary’s level of health and their ability to comply with the plan’s medical underwriting requirements, which could affect premiums or potentially exclude them from enrollment altogether. In most cases, the assessment takes only about five minutes and is done during a face-to-face conversation with a broker or agent.

In addition to evaluating a beneficiary’s health status, Medicare Advantage and Medigap agents also earn money by helping them complete the required annual enrollment process. This can include completing the required online enrollment through the Medicare website and submitting enrollment paperwork to the Medicare Center for Medicare and Medicaid Services CMS.

Some Medicare Advantage and Medigap agents are independent and work for themselves, while others work as employees of a brokering agency that contracts with multiple insurers to help them reach and enroll beneficiaries. The agencies provide administrative support, including marketing, technology infrastructure, and compliance; and they make payments to agents based on the number of plan enrollments.

The agencies and the agents themselves do not disclose to beneficiaries how much they pay their workers based on the number of Medicare Advantage, Part D, or Medigap enrollments they generate. Rather, they may report total compensation to beneficiaries as “salary and commissions.”

Independent Medicare agents and brokers can be an invaluable resource to Medicare beneficiaries as they narrow down their coverage choices. These individuals can give them access to a range of insurers and plans and are able to negotiate terms and premiums to create a policy that fits their client’s specific needs.