How to know if a Medicare agent is legitimate?

Question

Robert Vaughan, R.Ph., MBA · Accepted Answer

Your first step should always be verifying their insurance license information on the state’s Department of Insurance (DOI) website. Beware of door-to-door sales; Medicare agents cannot solicit business at your home without an appointment and Medicare will never send an agent to your home to enroll you into a plan. A legitimate Medicare agent will take the time needed to understand your specific needs and recommend products to meet those needs. Look for an agent that represents multiple private insurance companies. They should lay out all your coverage options (Medicare Supplement plans, Medicare Pharmacy (Part D) plans, and Medicare Advantage plans) and provide unbiased guidance. You can also search the internet (Google) to see if they have any reviews or ask for client references.

Answered by Robert Vaughan, R.Ph., MBA on May 7, 2025

Broker Licensed in CA, AZ, NM, NV & TX

Answered by Robert Vaughan, R.Ph., MBA Medicare Insurance Agent

Larry Dalton · Answer

All insurance agents who sell Medicare plans must be licensed in the state where you live and registered with that state. These agents are assigned a National Producer Number (NPN) by the state of their residence, which indicates their licensing status. Insurance commissions in all states can verify that the agent is a licensed professional authorized to provide you with any insurance policy. They must be registered with each state.

Answered by Larry Dalton on May 5, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Charles Boone · Answer

In my opinion, a legitimate Medicare agent or broker will assist individuals in finding a plan that best suits their specific needs rather than forcing them to fit into a pre-determined plan. While some agents or brokers may attempt to sell you specific benefits of a plan without knowing your medical history, others will take the time to gather information from you, such as your current medications, preferred providers, and other relevant details. This allows these agents or brokers to ensure that the plans they present cover your medications at the lowest possible cost and include your preferred providers in the network.

Answered by Charles Boone on May 5, 2025

Broker Licensed in OH

Answered by Charles Boone Medicare Insurance Agent

Melanie Baxter Black · Answer

You can look up any licensed Agent in the State of Texas visiting Texas Dept of Insurance website: 

    https://txapps.texas.gov/NASApp/tdi/TdiARManager

This will show you if the agent is active, currently licensed and what insurance companies they are contracted with.

Joseph Peck · Answer

Licensing is public knowledge. You can look up on your states government site or on NIPR. You can also ask them for their license number.

Joanna Gebhart · Answer

When discussing Medicare with an agent it is important to make certain that they have a current license with the state you are in.  You can go online to the states insurance website and search for Medicare agents to confirm their legitimacy.

If they advertise and/or give you a business card they must have their Insurance License Number on the card.  Licensed agents spend many hours in the summer learning about new changes for the upcoming year and are tested by each carrier they represent to make sure they are re-qualified each year.

Bill Wheeler · Answer

If in doubt request to see their insurance agent license. Authorized by the state  they originated in.

Elayne Cotton · Answer

A legitimate Medicare agent will be morally compliant at all times with all the rules and guidelines that are set in place by the federal agency, Center for Medicare & Medicaid Services. They will be properly licensed in all states where they offer services. They will be properly approved and accredited by the carriers whom they are representing.

Answered by Elayne Cotton on May 6, 2025

Agent Licensed in CO & TX

Answered by Elayne Cotton Medicare Insurance Agent

Fred Manas · Answer

To determine if a Medicare agent is legitimate, verify their license and certifications with your state's insurance department and the Centers for Medicare & Medicaid Services (CMS). Look for independent brokers who can compare multiple plans and avoid agents who push specific plans or offer excessive incentives. 
Key points to look for in a legitimate Medicare agent:
License and Certification:
All Medicare agents must be licensed in the state where they sell plans and certified by the insurance companies they represent. 
Independent Broker:
Independent brokers can offer plans from multiple companies, providing a broader range of options. 
No Sales Pressure:
A legitimate agent will educate you about your options and won't pressure you to choose a particular plan. 
Specialized Knowledge:
Look for agents who specialize in Medicare and understand the nuances of different plans. 
Avoid Excessive Incentives:
Legitimate agents should not offer gifts, free meals, or cash incentives to enroll in a plan. 
No Door-Knocking or Unsolicited Calls:
Legitimate agents will not visit your home uninvited or make unsolicited phone calls. 
Be Skeptical of Vague Answers:
If an agent gives vague answers or avoids providing specific details about coverage, it's a red flag. 
Check Reviews and References:
Look for online reviews or ask for client references to gauge the agent's reputation and experience. 
Report Suspicious Activity:
If you encounter any unethical behavior or suspected scams, report it to the CMS and the FTC.

Marcie Barnes · Answer

Every licensed agent is provided with a National producer number.  You can ask for that number and verify them on Google with their name and NPN.

Mike Henry · Answer

Check with the state board of insurance in your state. Every Agen has to pass a test to sell in his/her state. Interview 2-3 agents.

China Conley · Answer

You can ask for the agent's NPN and look it up on the National Insurance Producer Registry. You will be able to see their information which proves they are legit.

How to know if a Medicare agent is legitimate?

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How to know if a Medicare agent is legitimate?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website