What a Medicare office cannot help you with

In short: A licensed agent is genuinely useful for choosing and keeping coverage, and it costs you nothing. But several common Medicare problems are not theirs to solve, and knowing which is which saves a wasted trip. Nothing below is a criticism of agents. It is the honest boundary of the job.

What an agent is good for

Comparing the plans available where you live, explaining what a change would mean for your doctors and prescriptions, enrolling you, and being the person you call next year when your plan sends its notice. You pay nothing for this. The insurance company pays the agent a commission, and your premium is the same whether you enroll through an agent or go straight to the insurer.

What they cannot do

Change your Part B premium, or fix how it is deducted. That is Social Security, not the agent and not the plan. Call Social Security at 1-800-772-1213. If your premium is higher because of your income and your income has since dropped, Social Security is also the one that reconsiders it.

Sort out your Medicare enrollment itself. Signing up for Part A and Part B, a missing Medicare card, or a wrong start date all go through Social Security. An agent can tell you what to ask for, but cannot do it for you.

Appeal a denied claim. That is between you and your plan, with a formal appeals process behind it. Your plan's member services line starts it. Your state's free counseling program will help you through it at no cost, and they are genuinely good at this. 1-800-MEDICARE can explain the stages.

Decide whether you qualify for Medicaid or help paying your premium. Eligibility is a state determination. Agents can point you at the programs, but only your state Medicaid office or Social Security can say yes or no.

Help with a policy a different agent sold you. This surprises people, so it is worth being blunt about. An agent can only service clients who enrolled with them. If someone else signed you up, even at an office with a similar name in another town, that agent is your agent of record and the one who can act on your policy. Your enrollment paperwork names them, and your plan's member services line can tell you who it is. We wrote a separate guide on this: I already have a plan and need help.

Tell you which plan is best in the abstract. They can lay out what each one would cost you and whether your doctors and drugs are covered. The decision stays yours, and a good agent will say so.

Who to call instead

If you need	Call
Part B premium, enrollment, a missing card	Social Security, 1-800-772-1213
A claim denied, or an appeal	Your plan's member services, then your state counseling program
General Medicare questions, any time	1-800-MEDICARE
Free unbiased counseling near you	Your state program, listed on each of our state pages
Help paying premiums, Medicaid	Your state Medicaid office or Social Security

Your state's free counseling program deserves a particular mention. It is independent, it sells nothing, and for appeals and Medicaid questions it is often the better first call than anyone else on this page, including us.

Why we put this in writing

Because a directory that only tells you what it is good for is not much use. If you walk into one of these offices with a problem an agent cannot solve, you should find that out in a minute, with a phone number, rather than after a wasted afternoon. Find an office →