Need a Medicare Advisor in North Carolina? Beware of Red Flags!

Red flag, warning about Medicare advisors in North Carolina

If you’re nearing your 65th birthday, chances are you’ve already been bombarded with Medicare marketing calls and advertisements. While some of these may be from reputable sources, others will lead you into selecting the wrong Medicare plan based on your needs.

Since we’re currently in the middle of Medicare’s Annual Election Period, now is a great time to talk about five red flags you should be aware of when looking for a Medicare advisor in North Carolina – or anywhere else in the U.S., for that matter!

Red Flag #1: Door-to-Door Salespersons

Remember the days of door-to-door sales? You might have someone selling encyclopedias, pots and pans, or kitchen knives. Surprisingly, some insurance agents also use this tactic.

Face-to-face conversations are always helpful, especially when it comes to a topic as confusing as Medicare. But if someone shows up on your doorstep that you weren’t expecting, this is a red flag. Unsolicited insurance agents often have their commissions at the forefront of their minds, and they may only work with one insurance company. If you aren’t presented with multiple options from a variety of carriers, you should proceed with caution.

If you decide to invite the person in to discuss your Medicare plans, don’t make any decisions on the spot. Gather the information they give you, and then do your own research, or reach out to another advisor to get a second opinion. These are important decisions that you should not make quickly.

Red Flag #2: Pop-Up Insurance Booths

Many big-name prescription retailers allow insurance agents to have a temporary booth in their stores. In almost all cases, these agents only work with one specific plan, or are at least trying to enroll as many people in that plan as possible. It’s unlikely they’ll be willing to compare plans from other insurance companies. This is another red flag.

Plus, unless your advisor has a more permanent location, they may not be equipped to offer year-round support after you enroll. Just as we advised with the door-to-door salespeople, gather information if you’d like, but avoid enrolling in anything right away.

Red Flag #3: Failure to Verify Providers and Prescriptions

If you’re enrolling in Medicare Advantage or Medicare Part D, it’s imperative that your advisor check your providers and prescriptions. If an advisor doesn’t ask you about these things, that’s a giant red flag!

Medicare Advantage plans work with certain provider networks. Not all providers accept all Medicare Advantage plans. If you enroll in a plan that your provider doesn’t accept, you’ll pay higher out-of-pocket costs, potentially the entire bill.

The same is true of Part D prescription drug plans. Each Part D plan has its own drug formulary. If your prescription isn’t on the formulary, you won’t have coverage.

If an advisor doesn’t ask you these questions, you should find another agent right away.

Line of red flags, warning about Medicare advisors in North Carolina

Red Flag #4: Unsolicited Medicare Calls

Medicare and Social Security seldom reach out to beneficiaries via a phone call. If you get a call from someone claiming to be from one of these offices, your alarm bells should be blaring!

In most cases, the person probably got your information from a form you submitted online. You may have given your name and phone number in exchange for a free download or to see plan information. That information is then sold to insurance agents, who are allowed to contact you about Medicare plans.

If you aren’t sure who you’re speaking with, the best thing to do is hang up, look up the phone number online, and then call them back. This ensures that you’re talking to the company they claim to be calling from. It’s an extra step for you, but it’s the best way to prevent someone you don’t know enrolling you in a plan you don’t want.

Red Flag #5: No CMS Disclaimer

Independent insurance brokers (like us) will work with a variety of companies so they can compare plans and find the one that works best for your situation. However, it’s nearly impossible to be able to represent all plans in your area. There are simply too many options, and it would be too difficult for an advisor to be knowledgeable about all of them. Most agencies will pick the top plans and companies and then offer those to their clients.

Because there has been some confusion and misrepresentation in this area, the Centers for Medicare and Medicaid Services established new rules in 2022. They now require all phone calls to begin with a disclosure stating, “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all of your options.”

If your advisor overlooks this, it’s a cause for concern. Exercise caution if you’re talking with an agent who claims to represent all insurance companies. That statement is probably a bit of a stretch.

Trust Carolina Senior Benefits

Entering the world of Medicare, particularly as a newcomer, can feel like traversing a complex maze riddled with potential pitfalls. The journey gets trickier when representatives tell you exactly what you want to hear without revealing the full picture. Understanding what to inquire about when you’re new to Medicare isn’t always straightforward.

Carolina Senior Benefits is here to assist you. Our services won’t cost you a dime, and our advisors will give you tailored Medicare advice you can trust.