Picking a Medicare plan is a personal and consequential decision — especially if you have one or more chronic conditions to manage. To maintain health and financial safety, you’ll want a plan that keeps your medical costs predictable, allows you to see your current specialists, and covers prescription drugs you’re taking. Read on to find out if working with a broker is an ideal way for you to enroll in a Medicare Advantage plan when you have chronic conditions.

Pros and cons of enrolling in Medicare Advantage with a carrier

There are pros and cons to enrolling in Medicare Advantage directly through an insurance carrier’s captive agent. The main benefit is that you receive direct access to that carrier’s proprietary customer service tools. An agent who works directly with one carrier will also have in-depth knowledge about their products to a granular level, because these are the only plans they offer.

Enrolling in a Medicare Advantage plan directly through an insurance carrier has strict limitations. While a carrier’s captive agent will have deep, granular knowledge of their specific products, they are legally bound to only sell that single brand. When an agent works strictly with one carrier, they can’t tell you if another carrier’s plan covers your prescription drugs better, is cheaper, and has all your providers in-network.

If you are living on a fixed income with chronic conditions, having multiple options gives you more flexibility and choice when making your Medicare Advantage enrollment decision.

What to know about working with an independent broker to enroll in Medicare Advantage

Independent insurance brokers, like SmartMatch, represent multiple insurance companies so you can compare Medicare Advantage plans from as many as a dozen carriers.

When a broker’s fees are based on commission, there may be an incentive for them to sell high-cost plans to make more money. SmartMatch agents receive a flat rate from carriers, so there is no pressure to sell more expensive plans. Their goal is to connect you with a plan that retains your doctors, lowers prescription costs, and saves you money.

SmartMatch licensed insurance agents have software that allows them to put your medications and doctors into a database and compare plans across different carriers. In doing this, they can compare a wide range of Medicare Advantage plans to manage your chronic conditions. SmartMatch agents also screen for Chronic Special Needs Plans (C-SNPs) across different carriers. These plans are designed for people with severe chronic conditions, including diabetes, heart failure, and end-stage renal disease. C-SNPs offer no-cost or low-cost drugs to treat these conditions, care teams to help navigate treatments, and other benefits tailored specifically toward this care (like transportation to and from dialysis appointments).

Choosing from dozens of Medicare Advantage plans can be overwhelming. Working with a Medicare broker versus buying direct means having a trusted advisor to guide your enrollment decision and narrow down the best possible plan for you.

Potential Medicare Advantage scenarios with chronic illnesses

There are a few scenarios that can throw off your care when you have one or more chronic conditions. Independent brokers can help you weave through plans to best manage these potential pitfalls.

Losing access to specialists – Continuity of care is especially important with a chronic condition. Having the same specialist reduces your risk of medication errors and helps you better manage your care. Having a long-term relationship with a doctor means they understand your medical history and can watch for subtle health changes that may impact disease progression.

Losing coverage for a needed prescription – Medication adherence is critical for managing chronic conditions. Making sure you have insulin or heart medication could be the difference between life and death. You don’t want your prescription costs to go up or lose access to a medication when a new plan period begins.

Reductions in supplemental benefits – Over time, some Medicare Advantage plans have cut back their supplemental benefits. But if you suddenly lose transportation to doctor’s appointments or a spending allowance for healthy groceries, it can derail your health goals. Getting a plan with supplemental benefits – and having an agent who ensures you are using them to their fullest – can help manage your chronic condition.

Independent brokers have access to a wide range of plans so they can help you find one that covers your necessary prescriptions, has all your specialists in-network, and has all the supplemental benefits you need.