Medicare Questions & Answers: Agent Interview
Agent Interview Q&A
Showing 30 questions
What do you enjoy most about working with Medicare clients?
I truly enjoy working with Medicare clients because it gives me the opportunity to make a meaningful difference in their lives. Medicare can be a complex and overwhelming monster, and I take great satisfaction in helping my clients navigate their options with clarity and confidence. I thoroughly enjoy clarifying Medicare for my clients, ensuring they fully understand their choices, and guiding them toward the best coverage for their specific situation. There's nothing more rewarding than seeing the relief and peace of mind that comes when seniors feel secure in their healthcare decisions. My goal is always to provide personalized, thoughtful service so that each client gets coverage that truly meets their needs.
How do you educate clients who are completely new to Medicare?
I give them a little history of Medicare and explain the two different ways one can take their Medicare coverage - either Original Medicare with a Supplement and a drug plan for the least restrictions, or a Medicare Advantage plan that also includes other benefits, like transportation, an over-the-counter (OTC) catalog, dental, vision, and more depending on their plans in their area.
What is one of the the most common misconceptions people have about Medicare?
One of the most common misconceptions about Medicare is that it covers all healthcare costs for seniors. Turns out, Medicare doesn't cover every single healthcare expense. Additionally, many assume it includes long-term care (like nursing homes) or dental, vision, and hearing services, but these items are not covered under original Medicare. People often learn this the hard way when they realize they need supplemental insurance like Medigap, Medicare Advantage, and other tertiary coverage options to fill those gaps. It’s a rude awakening for those who think Medicare = free healthcare, hence the need to fully understand your options to make the best decision for yourself.
Can you describe a time when you helped a client navigate a complex Medicare issue?
I recently met with a new client that thought he was covered for everything. Upon asking several questions, it was discovered that he had lost his medicaid, extra help, his medicare advantage plan, and his drug coverage! In other words all he had was orgianl medicare parts A and B.With lots of due diligence I was able to enroll him into a proper medicare advantage plan with drug coverage. We also did a new application for "Extra Help". I communicated with his son the urgency of obtaining specific documents so that we could reapply for his medicaid.
It is expected that in the next 6-8 weeks we will have him receiving his extra help benefits and his medicaid!
What role do you think technology will play in the future of Medicare?
Advancements in technology are poised to transform Medicare in the coming years. Telemedicine, which saw explosive growth during the COVID-19 pandemic, is likely to become a permanent fixture in Medicare’s coverage. Other technological innovations, such as artificial intelligence (AI) and wearable devices, have the potential to improve care delivery and outcomes. However, integrating these technologies into Medicare will require addressing challenges such as data privacy, reimbursement policies, and ensuring equitable access for all beneficiaries.
What's the difference between a Medicare broker and a Medicare agent?
The main difference between a Medicare broker and a Medicare agent is that brokers represent multiple insurance companies and can present a broader range of Medicare plans, while agents typically represent one insurance company and offer a more limited selection of plans.
What’s an underrated benefit of Original Medicare that many people overlook?
The most underrated benefit of Original Medicare is freedom of choice. With Original Medicare you can see any provider as long as they take Medicare. no referrals are needed and it travels well. The coverage is Nation wide.
If you had to pick just one, what’s the worst Medicare-related decision someone can make?
In my professional opinion, the worst Medicare-related decision is choosing a plan without assessing one’s individual circumstances and relying instead on unsolicited advice from others. I frequently encounter clients who select coverage based on someone else’s experience, only to discover it doesn’t align with their specific healthcare or financial needs. This misstep often leads to unnecessary complications or expenses that a tailored evaluation could prevent.Why do some clients ignore your advice and end up in bad Medicare plans—what makes them resistant?
Some clients hesitate to follow my advice because of a common misconception that Medicare advisors like me drive up their premiums or costs due to commissions, when in reality, our guidance doesn’t change what you pay—plans and pricing are set by insurers and Medicare, not us. There’s also a false narrative that we can push you into specific plans for higher payouts, but the truth is, we earn the same regardless of the provider or product, so my focus is purely on what fits your needs best. Ignoring tailored advice can lead to picking the wrong plan, missing out on key benefits, and facing unexpected costs that hit both your health and wallet hard.If you could change one thing about the Medicare system, what would it be and why?
Medicare is very complex. The cost of prescription drugs are high and it's difficult for some clients to fill their prescriptions due to the cost. It would be great if pricing was adjusted for Medicare clients
What shift has been observed in Medicare spending, particularly regarding Medicare Advantage plans?
Some plans which were in place in 2023 and 2024 have had their Maximum Out Of Pocket (MOOP) increase in 2025.
What do you like most about being a Medicare agent?
I really enjoy helping seniors navigate Medicare, as it can be quite confusing. Not only do I help my clients with applying for Medicare, but I also take pride in getting them into the plan that best suits their needs, regardless whether it is an Medicare Advantage or Medicare Supplement plan.Knowing my clients enables me to determine if they qualify for any additional benefits through the state. I am also proficient at helping my clients solve issues that may arise, as I have access to solutions outside of their plan.
My clients are part of my extended family!
How is Medicare Advantage expected to evolve in the future?
The future of Medicare will likely see further expansion of MA, driven by consumer demand for more comprehensive coverage and the potential for cost savings through managed care. However, this growth also raises concerns about: Equity: Ensuring that MA plans provide equitable access to care for all beneficiaries, including those in rural or underserved areas. Oversight: Strengthening oversight to prevent fraudulent practices and ensure plans deliver on their promises.
I got a call from a “Medicare agent” promising me free groceries and I almost fell for it. Why is this kind of marketing allowed?
Medicare is trying to stop these unwanted calls. Even if your name is on the Do Not Call list, they still reach out to you. Most of these calls are made offshore and then transferred to an agent in the U.S. upon you answering the phone, this is what I have been told. I am 65 and have blocked over 600 numbers on my phone.Regarding the information about the free grocery card, it is partially correct and depends on your qualifications, including your location, the type of plans, your health, and on Medicaid. These plans are available through some Medicare Advantage plans.
How might artificial intelligence change how Medicare approves claims in the future?
AI could transform Medicare claims approval by speeding up the process, spotting patterns, and flagging errors faster than today’s manual reviews—I see it analyzing data in real time to cut delays. My hope is to drive this change to curb fraud, waste, and abuse, boosting efficiencies throughout, which is practical if the tech’s designed to verify claims against solid benchmarks and provider records. With the right system, I’d work to ensure approvals are tighter and taxpayer money goes further.
How will advancements in wearable health tech (like smartwatches) integrate with Medicare?
That is a great question. There a few Medigap carriers who will give you a discount on your premium. I just visited a new client today and she has an Apple Watch and will get a monthly discount. This carrier I just sold gives you a discount if you have an Apple Watch or a Fitbit.What are some lesser-known benefits or services that my Medicare plan might cover that I could be missing out on?
This is a perfect question, and a great one especially in today’s time, as Medicare Advantage plans are introducing more creative and innovative benefits to differentiate themselves. You might find lesser-known Medicare Advantage perks like quarterly allowances for rent, utilities, groceries, over-the-counter items like pain relievers, or even transportation to medical appointments and gym memberships for wellness programs. Meanwhile, Medicare Supplement plans, such as G or N, often include a valuable international travel benefit for emergency care abroad, which can be crucial if you’re overseas and need treatment unexpectedly.
What’s your go-to strategy for helping someone decide between Medicare Advantage and Medigap?
I have a seven question algorythm that is 99% accurate. Seven questions and the appropriate strategy is evident.
What’s a common Medicare myth that even some agents still believe?
I'd say that some agents still think they have to take additional tests in order to get a non-resident license.
What are the most overhyped benefits of Medicare Advantage plans that seniors should be wary of?
Benefits that are advertised nationally that only a super small percentage of the population (usually poverty level) qualify for. It's misleading for our senior population and creates confusion when there doesn't need to be any.
What are the red flags I should look for when interviewing agents? I want to make sure I'm not just getting sold to but genuinely advised.
Building trust starts at the first call. Let the Broker know your concerns then sit back and listen. The Broker should share their background…show their License when requested…offer references if necessary. The “rede flags” are failing to produce their License, failure to explain how the process works to obtain Medicare and then ask the appropriate questions of the client.A key “red flag” is if the Broker only works with one or two Insurance Carriers…the key to getting the best Plan for yourself is to work with a Broker Licensed and Certified by all of the Major Carriers in your area so you are not pushed into a Plan not right for you. And a Broker should never ask for or accept any fee for helping you as the Carriers will pay his or her fee.
Should Medicare cover dental, vision, and hearing, or would that just make it more expensive for everyone?
I believe Medicare should have more dental, vision, hearing, and preventive care services built into the traditional system, just like many Medicare Advantage plans offer these services within their programs.
What’s the biggest frustration Medicare agents have when helping clients enroll?
Insurance companies don’t fill in Medicare brokers on changes that a client may make. The biggest frustration ends up being a lack of communication, Because when the client calls up and says that they’re frustrated with Something, they have to fill in the Medicare broker on what’s going on. This can be alleviated with simple open communication.How much is spent on healthcare per year the U.S., and what does this amount represent per person?
The 2023 CMS Healthcare Expenditure Report revealed an eye-opening total of $4.9 trillion spent on healthcare, averaging about $14,570 per person.
How could a shrinking workforce affect Medicare funding in the next 20 years?
Medicare is funded through the workforce for future generations which is why its very important that every person working is contributing to this program. We have many workers in the US who are either self-employed or undocumented who are not contributing, that gap needs to be fixed by having a legal path to citizenship for those workers who will also benefit from Medicare when they retire.Is Medicare becoming more expensive over time, and will it ever be unsustainable?
Medicare costs have certainly risen over time—Part B premiums went from $144.60 in 2020 to $185 in 2025, and I’ve noticed Part D premiums spiking too, largely due to the Inflation Reduction Act shifting some expenses around—though recent crackdowns on waste, fraud, and abuse, like overpayments and non-qualified services, might temper future hikes compared to past jumps. The program’s sustainability gets questioned as more folks age into it, but I’m optimistic that sharper oversight and drug price caps from the IRA could keep things manageable moving forward.
Why does Medicare have so many coverage gaps, and is it designed that way on purpose?
When clients ask me this question, I usually answer, "To keep me busy". Seriously, it is an ever changing maze of rules and regulations. Once you think you have everything figure out, the government changes something and throws a curve ball. Working with an independent insurance advisor, allows you to reach out if you have an issue or a question and any point during the year.
Should there be stricter regulations on Medicare Advantage marketing and sales practices?
No. The regulations make is harder for honest people and the seniors. The issues is that the dishonest people are NOT following the rules. Calling Seniors with permission to contact forms. They are signing them up without Scope of Appointments.The high pressured scammers are the problem and not following any rules. I get calls every 10 minutes from people trying to pressure me and make false claims about insurance and I am a broker!!
What’s the most frustrating misconception you have to clear up with clients about Medicare every year?
First, It’s essential to clearly understand the differences between Traditional Medicare with a Medigap plan vs Medicare Advantage.Second item is the mistakenly think that starting with a low-cost plan is the best option; however, this isn’t always the case with insurance companies under the Medigap program. After the first four to five years, premiums can increase significantly, making it difficult for those with health issues to switch to a more affordable plan. Often, individuals are left at point in life with no choice but to transition to an Advantage plan a more affordable monthly rate and giving up their freedom of choice. Being informed about these options can lead to better long-term decisions regarding healthcare coverage.