Jane Dotson
Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Medicare does not come to your house to sell insurance. Insurance agents and brokers selling Medicare plans are not allowed to come to your house uninvited to sell or endorse anything. However, they can call you if you are already a member of the plan or have given them permission to contact you. Agents and brokers must be licensed by the state and are required to follow specific rules, such as providing plan materials, explaining plan options, and collecting enrollment forms. Selling a home generally does not affect Medicare benefits but may impact monthly premiums if taxable income increases significantly. Understanding the intricacies of Medicare and its various options can help agents sell more policies and better serve their clients.
| Characteristics | Values |
|---|---|
| Can Medicare come to your house to sell insurance? | No, Medicare insurance plans are sold by independent agents and brokers who are licensed by the state. |
| Can Medicare take your house? | No, Medicare cannot take your house. However, if you are the sole owner of a house and on Medicare, Medicare can take the house if it is an asset belonging to the estate of a deceased person. |
| Can selling your house affect your Medicare benefits? | No, selling your house will not cause you to lose your Medicare benefits. However, it may lead to higher Medicare premiums if your taxable income increases. |
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What You'll Learn
Medicare cannot take your house
Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. It is divided into two parts: Part A, which covers inpatient or hospital stays, and Part B, which covers outpatient or medical care. Although Medicare does not cover assisted living facilities, it is a common misconception that the program can take your house. This misconception often leads older people with health problems to sell their homes unnecessarily to cover medical expenses.
However, there are certain situations in which Medicare may be able to take your house. If all owners of a house are on Medicare and the house is an asset belonging to the estate of a deceased person, Medicare can take the house as part of the probate process. Additionally, if one owner is not on Medicare and there are no other assets that can be sold to pay for long-term care costs, Medicare can take the house.
It is important to note that Medicaid, a different government program, may be able to place a lien on your home or take possession of it under certain circumstances. Medicaid Estate Recovery Programs (MERP or MER) allow states to recoup expenditures for long-term care costs after the beneficiary's death. However, there are exemptions to this, such as when a spouse, child under 21, or disabled child of any age is living in the home.
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Selling your home may increase your Medicare premiums
Medicare does not come to your house to sell insurance. In fact, Medicare is a federal program that provides healthcare coverage to individuals 65 years or older.
Now, selling your home may increase your Medicare premiums, but it won't cause you to lose your Medicare benefits. Medicare premiums are based on your tax return from two years ago. So, if selling your home pushes you into a higher income bracket, you could see an increase in your Medicare premiums. This is because high-income earners typically pay higher Medicare premiums. In 2023, individuals with a modified adjusted gross income (MAGI) of over $97,000 per year or married couples filing jointly with a MAGI of over $194,000 were considered high earners and paid a surcharge called the Income-Related Monthly Adjustment Amount (IRMAA) for Medicare Part B and Part D. The IRMAA surcharge is not permanent, and if your income drops below the threshold, you will pay the standard Medicare premiums the following year.
If you sell your home and move, you may need to change your Medicare plan. Medicare Parts A and B are accepted across the United States, but Part C (Medicare Advantage) is often provided by a regional group, so you may need to find a new plan if you move out of your current provider's service area. Additionally, if you receive assistance due to a disability, selling your home and increasing your income could result in adjustments to your government subsidies.
It's important to note that Medicare cannot take your house. This is a common misconception, and while Medicare may be able to recoup expenses from the sale of a house if all owners are on Medicare, they cannot take ownership of the house itself.
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Medicare salespeople earn higher commissions on certain plans
Medicare salespeople or agents are licensed individuals who help beneficiaries choose the right insurance coverage. They are paid commissions directly by insurers, and these commissions are set annually by the Centers for Medicare and Medicaid Services (CMS) based on fair market value (FMV). While insurers determine the exact compensation levels, they usually pay close to the CMS maximums to incentivize salespeople to sell their products.
CMS-regulated maximum commissions differ between Medicare Part D prescription drug plans (PDP) and Medicare Advantage Prescription Drug (MAPD) plans. For instance, the maximum commission for first-time enrollment in MA was $573 per beneficiary in most parts of the US in 2022, while California had a higher maximum of $715 due to its higher cost of living. Commissions for standalone Part D plans were lower at $87 nationally. Commissions are also paid when beneficiaries switch plans or stay enrolled.
Medicare Advantage commissions are higher in the first year of enrollment compared to renewals, and they vary by state. For instance, in 2024, the commission for initial MAPD sales in California and New Jersey was $762, while in Connecticut, Pennsylvania, and Washington, D.C., it was $689. Commissions for renewals in the former states increased to $381 per member per year, while commissions for renewals in the latter states increased to $689 per member.
Medicare salespeople earn higher commissions for enrolling beneficiaries in Medicare Advantage (MA) plans compared to traditional Medicare with Medigap or standalone Part D plans. This financial incentive may lead agents to recommend MA plans even when they may not be the best option for the beneficiary's health needs. As a result, seniors may end up in plans that do not provide optimal care or access to necessary services.
To increase their commissions, salespeople can start an agency and negotiate override commissions paid to agencies in return for broker support. This allows them to earn additional revenue beyond the maximum broker commission defined by CMS.
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Marketing rules for Medicare plans
Medicare plans and people who work with Medicare must follow specific rules when marketing their services. Firstly, they cannot ask for personal information such as bank account or credit card details over the phone unless it is required to process an enrollment request. They are also prohibited from coming to your home uninvited to sell or endorse anything. Medicare agents can only call if you are already a member of the plan or have given them permission to contact you.
During a sales pitch, Medicare representatives are not allowed to sell non-health-related products, such as annuities or life insurance policies. They must also respect your wishes regarding the products you wish to hear about and can only discuss other plan options if you specifically request them. It is prohibited to pressure potential customers with statements like "you have to join this plan or you won't have coverage next year". Medicare plans cannot ask for payment over the phone or online and cannot offer cash or gifts worth more than $15 to entice enrolment.
Marketing materials must be distinct from educational activities, and the use of the name "Medicare" in product labelling and marketing is restricted. The use of superlatives like "best" or "most" is also prohibited. Medicare Advantage and Part D plan sponsors must provide promotional materials in the top 15 languages spoken in the US, aside from English. Websites and other materials must also be accessible for people with disabilities, adhering to Section 508 of the Rehabilitation Act.
In terms of marketing channels, Medicare Advantage plans utilize direct mailings, telemarketing, and advertising on radio, television, websites, and social media. Doctors are permitted to discuss the merits of various Medicare plans and provide communications materials but cannot offer marketing materials in healthcare settings. Common areas such as waiting rooms and cafeterias are considered acceptable for providing marketing information.
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Medicare insurance agents can build trust with clients
Medicare insurance agents can build trust with their clients by creating relationships and establishing themselves as knowledgeable, trustworthy, and reliable sources of information. Satisfied clients are more likely to recommend an agent's services to their friends and family, so it is important to strive for an exceptional customer experience. Agents should stay up-to-date on their products and services and take every opportunity to educate their clients on how these will benefit them.
Compliance is also a key factor in building trust. Agents must avoid unsolicited contact, such as texts, and instead use compliant email marketing with an opt-out option. They should also avoid sharing protected health information (PHI) via unsecured emails or voicemails and always use encrypted systems for storing or transmitting sensitive data. Additionally, agents should ensure that all marketing materials are pre-approved by CMS or carriers and include the required TPMO disclaimer.
To build trust, Medicare insurance agents should also be capable, qualified, conscientious, and licensed and registered in the client's state. They should work hard to reduce premiums while getting the client the most coverage available. Agents should also offer lots of different policy options, give their opinion on which insurance carriers are superior, and put the client's needs first.
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Frequently asked questions
No, Medicare does not come to your house to sell insurance. Medicare insurance is sold by independent agents and brokers who are licensed by the state.
Medicare plans and people who work with Medicare can give you plan materials, tell you about the plan options and how to get more information, give you an enrollment form, and collect your completed enrollment form. They can also leave business cards for you to give to friends and family.
No, Medicare cannot take your house. However, if you are on Medicare and inherit a house, Medicare can try to take it as part of probate. If all the owners of a house are on Medicare, then Medicare can take the house if it is an asset belonging to the estate of a deceased person.
No, selling your home will not cause you to lose your Medicare benefits. However, if you move to a new address, you may need to change your plan.
Yes, selling your home may lead to higher Medicare premiums if your taxable income increases. Medicare considers you a high earner if your modified adjusted gross income (MAGI) exceeds $97,000 per year if filing taxes as a single person or $194,000 for married couples filing jointly.
