Medicare Insurance Agency: How We Help

What an agency does

An independent agent appointed with several insurers can compare Medicare Advantage, Medigap, and Part D options available in your area, check your doctors and prescriptions against plan networks and drug lists, and help again each fall during Open Enrollment. Agents are paid by the insurers, so you don’t pay a fee for their help. Medicare.gov, 1-800-MEDICARE, and your State Health Insurance Assistance Program (SHIP) also give free, unbiased help; the national SHIP line is 877-839-2675.

Rules agencies follow

Federal rules shape how agents work. Third-party marketing organizations that represent more than one Medicare Advantage organization must give a disclaimer explaining that they don’t offer every plan in your area. Agents must agree with you on a Scope of Appointment, the products you want to discuss, before a sales appointment; a CMS rule effective June 1, 2026 removed the old 48-hour waiting period. And under a 2024 CMS rule, your personal information can be shared with another marketing organization only with your prior express written consent for each recipient.

2027 at a glance

CMS projects the average monthly Medicare Advantage premium will fall from $14.37 in 2026 to $12.00 in 2027, with about 5,532 plans offered and about 34 million people enrolled, roughly 47.4% of people with Medicare. CMS also says more than 99% of beneficiaries have at least one Medicare Advantage plan available and about 8 in 10 enrollees can keep their current plan at the same or a lower premium. Standalone drug plan premiums are projected to average $36 a month, up from $35.09.

KFF’s analysis of CMS data finds the average beneficiary has 28 Medicare Advantage plans with drug coverage for 2027, down from 32 in 2026 and a peak of 36 in 2024. Counties with no general-enrollment Medicare Advantage plan with drug coverage rose from 123 to 193; standalone drug plans are still available there.

How to read 2027 Star Ratings

CMS rates each Medicare Advantage contract from 1 to 5 stars, and the rating covers every plan under that contract. The 2027 ratings, released October 8, 2026, used up to 43 measures for plans with drug coverage, covering areas such as preventive care, chronic condition management, member experience, complaints, and drug safety.

Source: CMS 2027 Star Ratings fact sheet, October 8, 2026. A contract’s rating can differ from the company’s average, so check the specific plan on Medicare.gov.

Litigation also affects comparisons. A federal court ruled in May 2026 that CMS improperly used some measures, CMS recalculated 2026 ratings in June, and Alignment Health has sued over its 2027 rating, according to Healthcare Dive; SCAN and Alignment had sued over 2026 ratings. Ratings are one factor; a plan’s network, drug list, and costs usually matter more for your situation.

Insurers changing their footprint for 2027

Source: KFF analysis of CMS data, October 9, 2026. Counts exclude Special Needs Plans and employer plans.

Becker’s Payer Issues, a trade publication, lists insurers fully leaving Medicare Advantage for 2027, including Blue Cross and Blue Shield of Montana, Braven Health in New Jersey, Wellmark Blue Cross Blue Shield in Iowa and South Dakota, Blue Cross and Blue Shield of North Dakota, Christus Health Plan in Texas and New Mexico, ConnectiCare, WellSense, and Memorial Hermann Health Plan in Texas. It also reports Blue Cross and Blue Shield of Texas and of Oklahoma ending their Blue-branded Medicare Advantage plans while HCSC keeps HealthSpring plans in some counties. If your plan is leaving, you have a Special Enrollment Period and may have Medigap guaranteed issue rights.

Types of Medicare Advantage plans

Source: Medicare.gov. Medicare Advantage plans often require prior authorization for some services.

Out-of-pocket limits

Medicare Advantage plans must cap in-network out-of-pocket costs for Part A and B services. For 2026, KFF reports the federal limit is $9,250 in network and $13,900 combined for in- and out-of-network services in PPOs, and that the average plan’s in-network limit is about $5,421. Original Medicare has no out-of-pocket cap, which is one reason people pair it with Medigap.

Medigap basics

Medigap policies are standardized and sold by private insurers to help pay Original Medicare’s deductibles, coinsurance, and copays. The lettered plans are A, B, C, D, F, G, K, L, M, and N, and a plan with the same letter has the same basic benefits from any company. Plans C and F aren’t available to people new to Medicare on or after January 1, 2020; Plans D and G offer the same benefits except the Part B deductible. Medigap doesn’t work with Medicare Advantage and generally doesn’t include drug coverage, so most people pair it with a Part D plan.

Sources: Medicare.gov and CMS notices, October 2025 and October 2026.

When you can enroll or switch

Source: Medicare.gov, October 2026.

Avoiding Medicare scams

Medicare.gov says Medicare will never call you to sell you anything or visit you at your home, and that it calls for personal information only in limited cases, such as returning your call. Don’t join a plan over the phone unless you called and asked for help, and don’t give your Medicare or Social Security number to anyone who contacts you unexpectedly. The FTC adds that Medicare sends new cards automatically and for free.

Report suspected fraud to 1-800-MEDICARE (1-800-633-4227) or the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477). Medicare Advantage and Part D members can also call the I-MEDIC at 1-877-772-3379.

What Original Medicare doesn’t cover

• Eye exams for prescription eyeglasses
• Most dental care, such as cleanings, fillings, extractions, and dentures
• Hearing aids and exams for fitting them
• Non-medical long-term care (custodial care)
• Routine physical exams
• Cosmetic surgery
• Massage therapy
• Concierge care
• Care from providers who have opted out of Medicare, except emergencies
• Most care outside the United States

Checking a plan and insurer

• Networks. Confirm your doctors and hospitals are in the plan’s network.
• Drugs. Check each prescription on the plan’s formulary and its tier.
• Costs. Compare premiums, deductibles, copays, and the out-of-pocket maximum.
• Agent license. Confirm the agent is licensed in your state through your state insurance department.
• Star Ratings. Review the plan’s rating in Medicare.gov’s plan compare tool.

What an independent agency does

An independent insurance agency is licensed to sell policies from several insurance companies. Instead of quoting one company's products, an independent agent can compare options from the insurers the agency represents, explain the differences in coverage, and help you re-shop at renewal. The insurance company, not the agent, makes underwriting and claim decisions.

Blake Insurance Group is an independent agency. We work with clients by phone, email, and online in states where we are licensed, and we will tell you which insurers we can quote for your situation.

How we work

Blake Insurance Group serves clients by phone, email, and online in states where we are licensed. The insurers and plans we can offer depend on our appointments and your location; a company named on this page may not be available through us.

How to verify an insurer or agency

Before buying through any website or app, confirm who is selling you the policy and who will issue it:

1. Find the licensed agency or insurer named in the site's footer, terms, or license page.
2. Look up the agency or producer on your state insurance department's license search, or through the National Insurance Producer Registry (NIPR).
3. Look up the insurer on your state insurance department's company search to confirm it is authorized in your state.
4. Save the insurer's name and policy number once issued, since that is who handles claims.

A legitimate service will make this information easy to find. Be cautious if you cannot identify the licensed entity.

Sources

We checked the facts on this page against the sources below in October 2026. Plans, prices, and rules change, so confirm current terms before you buy.

• CMS: Medicare Advantage and Part D expected to remain stable in 2027 (Sep. 28, 2026)
• KFF: The average Medicare beneficiary has 28 MA-PD plan options for 2027 (Oct. 2026)
• KFF: Medicare Advantage plan availability for 2027 (Oct. 2026)
• CMS: 2027 Medicare Advantage and Part D Star Ratings (Oct. 2026)
• Medicare.gov: Compare Medicare Advantage plan types
• KFF: Medicare Advantage out-of-pocket limits
• Medicare.gov: Joining a health or drug plan
• Medicare.gov: Special Enrollment Periods
• CMS: 2026 Medicare Parts A & B premiums and deductibles (Nov. 2025)
• Medicare.gov: What Original Medicare doesn't cover
• 42 CFR 422.2267: Required materials and content (TPMO disclaimer)
• 42 CFR 423.2264: Beneficiary contact and Scope of Appointment
• ACL: State Health Insurance Assistance Program (Mar. 2026)
• Medicare.gov: Medicare fraud
• CMS: Contract Year 2027 Medicare Advantage and Part D final rule (Apr. 2026)
• Medicare.gov: Your Medicare in 2027: What's new and changing (Sep. 2026)
• 42 CFR 423.2274: Agent and broker requirements (data-sharing consent)

What to have ready for a Medicare review

These details help an agent quote accurately.

1. Medicare card. Your Medicare number and Part A and B start dates.
2. Doctors. Names of doctors and hospitals you want to keep.
3. Prescriptions. Drug names, doses, and pharmacies.
4. Current coverage. Any plan, employer, or Medicaid coverage you have.
5. ZIP code. Plans differ by county.

Medicare Insurance Agency FAQs

Related guides

• Medicare Advantage agents
• Medicare Supplement insurance
• Medicare Open Enrollment
• Choosing an independent Medicare agent
• Medicare Extra Help

Your next step

Request a review, and a licensed agent will compare Medicare plans available to us in your area. You can also use Medicare.gov or 1-800-MEDICARE to see all options.