If you are on Medicare, or about to be, the next three months are loud. Television ads with a 1-800 number. Glossy mailers that look official. Calls at dinner time from someone who says your benefits have changed.
Almost all of it is selling. Some of it is honest selling, some of it is not, and the honest kind still has a commission behind it — ours included. The question is not whether someone is paid. It is whether they start with your situation or with their plan. Here is how to tell.
What Medicare will never do
Start with the simplest filter. Medicare does not phone you to sell a plan. It does not call to tell you about new benefits you are entitled to, and it will not ask for your Medicare number on a call you did not start.
If a caller claims to be from Medicare, or from “the Medicare benefits department,” and asks for your number, hang up. If you are worried something genuinely needs attention, call 1-800-MEDICARE yourself using the number on the back of your card.
Your Medicare number is valuable to fraudsters for the same reason it is valuable to you. Treat it like a bank card.
What agents are not allowed to do
The rules on Medicare Advantage and Part D marketing are tighter than most people realise:
- No unsolicited contact. Agents and plans may not cold-call, text or knock on your door to sell these plans. They can contact you if you asked them to
- An agreed scope. Before a sales appointment, the agent has to record which types of plan you agreed to discuss, and should stick to them
- A required disclaimer. Anyone selling on behalf of more than one plan has to tell you that they do not offer every plan available in your area, and point you to Medicare.gov and 1-800-MEDICARE for the full picture
That last one is worth listening for. We carry the same statement on every page of this site, because it is true of every broker: no one is appointed with every carrier in every county.
The ten-second test
Did you ask them to contact you? Did they ask about your doctors and prescriptions before naming a plan? Did they mention they do not offer every plan in your area? If the answer to any of those is no, slow down.
How the pitches are built
Most Medicare advertising leans on a small number of hooks.
A dollar figure up front. “Up to” amounts for groceries, over-the-counter items or a Part B giveback. The words “up to” are doing the work. These benefits exist on some plans in some counties, and the amounts vary. They are also one line in a plan that has a network, a formulary and an out-of-pocket maximum — which the ad does not mention.
Urgency. “Call before benefits run out.” “Limited time.” The Annual Enrollment Period runs from October 15 to December 7 every year. Nothing about your options changes because you waited a week to think.
The official look. Envelopes with eagles, flags, “benefit notice” headings and reply-by dates. If it does not come from the Centers for Medicare & Medicaid Services or your current plan, it is advertising.
A single question. “Do you have Medicare Parts A and B?” Answering yes is often all it takes to be transferred to a licensed agent who is ready to enroll you on the call. That is the moment to ask what they know about your doctors.
What advice looks like
Advice starts with you, not with a plan. A useful conversation covers:
- Your doctors and hospital — checked against each plan’s network for the coming year
- Your prescriptions — exact names, strengths and pharmacy, priced on each formulary
- Your budget — not just the premium, but what a bad year would cost
- How you live — whether you travel, whether you split the year between states, whether you would rather pay predictably every month or as you use care
Only then does it make sense to name plans. And the recommendation should come in writing, with the reasons, so you can check it after the call. What that comparison should contain is set out in what a free plan comparison actually includes.
A good broker will also tell you when the right move is to stay where you are. If your current plan still covers your doctors and drugs at a sensible total cost, switching for a bigger allowance is often a step backwards.
About the word “free”
Our help costs you nothing, and that is true of most licensed brokers. The premium is the same whether you enroll through us, through a carrier directly or on Medicare.gov. Brokers are paid by the carrier you choose. We explain how that works, and why it does not push us toward one company, in how an insurance broker is actually paid.
Free does not mean neutral by default. It means you should ask how someone is paid, and expect a straight answer.
If you have already been switched
If you enrolled on a call and now are not sure what you agreed to, do not panic. During the Annual Enrollment Period you can change again, and the last valid enrollment before December 7 is the one that takes effect on January 1. From January 1 to March 31 there is a further window to change Medicare Advantage plans or return to Original Medicare.
Call your new plan, ask for the Summary of Benefits, and check your doctors and drugs against it. Or send it to us.
The calmer route
An annual coverage review is free, takes about thirty minutes by phone or video, and starts with your doctors and prescriptions rather than a plan name. You get the comparison in writing and the decision stays yours. When you are ready, book a time that suits you — there is no deadline pressure from us.
Frequently asked questions
Does Medicare call people to offer new plans?
No. Medicare does not call to sell you a plan or to offer new benefits, and it will not ask for your Medicare number on a call you did not make. If a caller says they are from Medicare and wants your number, hang up and call 1-800-MEDICARE yourself using the number on the back of your card.
Is it legal for an agent to cold-call me about Medicare Advantage?
Agents and plans are not allowed to make unsolicited calls, texts or door-to-door visits to sell Medicare Advantage or Part D plans. They can contact you if you have asked them to, for example by filling in a form or calling first. If you did not ask and they are pitching a plan, that is a red flag about everything else they say.
What is a Part B giveback plan?
It is a Medicare Advantage plan that reduces part of the Part B premium you pay. These plans exist in some counties, the reduction varies, and they usually trade it against something else — a narrower network, higher copays or fewer extras. They can be a good fit, but the giveback is one line in a plan, not a reason on its own to switch.