A Guide to Understanding a Medicare Broker vs Agent

Medicare is a complex program, and it can be difficult to know which type of representative you need to help you navigate it. There are Medicare agents and Medicare brokers, but what is the difference?

In this article, we will explain the key differences between these two types of Medicare broker vs agent, as well as what is the most important thing to look for when choosing one. Let's get started!

Is There A Difference Between a Medicare Insurance Broker and an Agent

Is There A Difference Between a Medicare Insurance Broker and an Agent?

Different companies use different terms to describe a broker or agent. Some companies will say a broker is independent and an agent works for only one insurance company.

Others say brokers can't sign you up for policies and agents can.

Lastly, they also say the difference between a Medicare insurance broker and an agent is that brokers have access to multiple plans from different companies while agents represent just one company.

So which one is right?

If you search different sites the terms are interchangeable. So what to do?

Ask the agent or broker one simple question...

Do You or Your Agency Represent One Insurance Carrier or Many?

If they represent one insurance carrier they are called a captive agent or licensed only agent. A captive agent represents numerous plans but they are limited to being from only one carrier. If that carrier does not offer a plan that fits your needs this agent is unable to suggest plans from other carriers in your area.

If they represent multiple carriers, they are independent agents or agency.

And neither type is better or worse than the other.

That's it. All the different terms people use and saying one is better than the other is just marketing spin.

So what is the MOST important thing about a Medicare Broker or Agent?

Does You Medicare Agent or Broker Put YOUR Needs First?

Your agent or broker should be an advocate for you, not just trying to make a sale.

They need to be licensed to access Medicare health plans. You can search for your agent online and confirm their license status.

Look for an agent or broker who takes the time to understand your needs and goals. One that knows all the Medicare options available and will explain each one so you can make an informed decision.

Not All Plans are Offered in Your Area

Different insurance companies offer different plans depending on your area. An independent broker or agent can help you compare plan options in your area and find the best fit for you. They can quickly research for you if your preferred doctor is on covered on each plan as well as which of your prescriptions will be covered on each of the plans.

This is one benefit of working with independent agents vs. searching for plans yourself or the limited options offered by captive agents.

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Do You Have to Pay Your Medicare Insurance Agent or Broker

Do You Have to Pay Your Medicare Insurance Agent or Broker?

No. Insurance agents and brokers are paid from the insurance company that offers the Medicare plan chosen by you.

Good Independent agents are not selling policies (in any case, you don't pay them). Their responsibility is to help determine which Medicare plans best fit your three core needs.

Health Coverage

Does your Medicare coverage offer the best health coverage for your specific needs?


Can you afford the premiums, co-pays and deductibles for your Medicare plan? Are your prescription drugs covered and what will be the out of pocket costs? Do you qualify for any zero premium plans?


Are doctors and hospitals near you in-network on your Medicare plan? Do the covered services fit with your lifestyle and budget?

Can you save money by going directly to the Insurance Company?

No, you will still pay the same amount if you enroll for coverage directly with the insurance company.

However, you may not choose the best plan for yourself without access to the different tools and research a knowledgeable agent can provide you.

Do I need to pay the agent for help if I choose to use a different insurance agent?


You are not required to use the same agent and you do not have to pay for help in finding a Medicare plan. Be careful of agents asking for fees - it’s illegal for Medicare agents or brokers to charge you a fee.

What if You Qualify for Medicaid Services

What if You Qualify for Medicaid Services?

An insurance agent can be a valuable resource for Medicare beneficiaries who also qualify for Medicaid. These individuals are often referred to as "dual eligible," and they may be eligible for additional benefits beyond what traditional Medicare offers. An insurance agent can help dual eligible understand their coverage options, including Medicare Advantage plans and Special Needs Plans (SNPs).

They can also help these individuals enroll in programs that provide assistance with prescription drug costs and other healthcare expenses.

Additionally, an insurance agent can assist with the enrollment process, ensuring that dual eligible are enrolled in the most appropriate plan for their needs. By working with an experienced insurance agent, you can make informed decisions about their healthcare coverage and receive the support you need to manage your health effectively.

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Medicare Beneficiaries - Get the Plan That Is Best For You

There are many different insurance companies, agents and brokers offering Medicare policies.

If you are looking for an experienced Medicare agent that has your best interest in mind, our team of licensed agents at EASY Insurance Plans will be happy to take the time and discuss your Medicare options.

Not turning 65 but looking for an independent agent to help determine what the best coverage health plans are available for you and your family?

We can compare your current health insurance coverage with other plans in your area to help you find the best fit.