Medicare guidance from O’Neal Insurance Group
Verify an agent before choosing coverage
Check the person’s state license, the plans they are authorized to discuss and the help they provide after enrollment. A business card or website title is only a starting point.
Start with the Nevada license record
Ask for the agent’s full legal name and Nevada insurance license number. Use the Nevada Division of Insurance’s Verify a License service and match the record to the person helping you. Check the status and lines of authority, and contact the Division if anything is unclear.
- Confirm that the license is current for the state where you live.
- Ask which insurers and specific products the agent can currently sell.
- Request written contact details and the agency name.
- Keep a copy of the license details and the plan information you review.
State licensing and Medicare training are different
For Medicare Advantage and Part D sales, CMS requires agents and brokers to be appropriately state-licensed and complete annual training and testing. CMS explains agent requirements and compensation.
AHIP is a training provider used by many insurers. The CMS requirement is annual training and testing; ask each insurer which training it accepts and whether the agent has completed its current product authorization requirements. A state license alone does not confirm authorization to sell a particular plan.
Questions credentials cannot answer
A license check is one part of choosing help. Ask the agent to explain the differences between Original Medicare, Medicare Advantage, prescription drug coverage and Medicare Supplement insurance in terms you understand.
- Which plans do you represent, and which options are outside your offering?
- How will you check my providers, medications and pharmacy?
- What costs could I face beyond the premium?
- What enrollment period applies to me?
- How are you paid, and whom do I contact if a problem comes up later?
Read the documents before deciding
Ask for the exact plan name, plan year, Summary of Benefits, Evidence of Coverage, formulary and provider directory. Have the agent point to the documents behind a recommendation. Save the comparison and verify important provider information with the plan and provider.
A recommendation should explain tradeoffs and include whether keeping your current coverage makes sense. Do not rely on a promised allowance, a carrier’s reputation or an advertised premium alone.
Planning for 2027 prescription costs
CMS lists a $700 standard Part D deductible and a $2,400 annual out-of-pocket threshold for 2027. Individual plans may have a lower deductible. These figures describe Part D, not a limit on all Medicare spending. See CMS Table V-2.
Ask for a full-year drug estimate using exact medications, doses and pharmacies. Budget separately for premiums and noncovered drugs. Confirm the published Part A and Part B amounts for the coverage year before making a budget.
Check independently
Use Medicare Plan Compare or call 1-800-MEDICARE to review options beyond the agency’s represented plans. SHIP offers independent Medicare counseling.
Continue your review
- How to choose a Medicare agent in Las Vegas
- Meet James O’Neal
- Understand Medicare Advantage plan types
Important disclosures
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 Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program to get information on all of your options.
O’Neal Insurance Group is not affiliated with or endorsed by the United States government or the federal Medicare program. Insurance services are provided by licensed agents in states where services are offered. Benefits, costs, networks, formularies and availability vary by plan, location and year. Confirm current plan documents before enrolling.
Talk through your next step
Ask questions, review the options we represent and decide whether a change fits your needs. There is no additional fee for our guidance; the agency may receive compensation from a represented insurer when enrollment occurs.
