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Agent Accountability
Cheat Sheet · Page 1 of 3
The Agent Accountability Cheat Sheet
Calm, plain questions and your federal rights — take this to any Medicare meeting.
You don’t need to be combative — just prepared. When you hear one of the phrases below, pause and read the calm reality before you respond.
When you hear these, just pause
They say: "You can always switch to a Medigap supplement later if you get sick."
The calm reality: In most states, once your one-time window closes, insurers can review your health history — and may say no. The door doesn’t always reopen.
They say: "It’s a $0-premium plan, so it’s completely free coverage."
The calm reality: $0 a month isn’t $0 in care. You take on copays up to a yearly out-of-pocket maximum that can reach thousands.
They say: "Look at all the extras — dental, a gym membership, a grocery card."
The calm reality: Those perks can change or vanish every year. The core medical coverage is the part that follows you.
They say: "Original Medicare has no cap, so you’re unprotected without this plan."
The calm reality: True alone — but informed people pair Original Medicare with a Medigap plan, bringing real out-of-pocket near zero.
They say: "It’s a free, state-sponsored educational seminar."
The calm reality: Government agencies don’t sponsor sales pitches. A required signature to attend means it’s a sales funnel.
They say: "A PPO lets you see any doctor, just like Original Medicare."
The calm reality: Out-of-network doctors aren’t required to take you, and your share can jump to 40–50%.
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theClearing
Medicare Education · joinclearing.com
Agent Accountability
Cheat Sheet · Page 2 of 3
Know your rights
Federal protections — quietly powerful when you know them.
No cold-calling
Agents generally can’t call, text, or knock unless you asked them to first.
Paperwork comes first
A Scope of Appointment must be signed before any plan pitch. Being rushed past it is a red flag.
Health insurance only
During a Medicare appointment, agents can’t pivot to life insurance or annuities.
No free meals
Sales events can’t buy you a full meal or a gift worth more than $15 — light snacks only.
Not where you get care
No selling or flyers in exam rooms, hospital rooms, or at the pharmacy counter.
"We don’t offer every plan"
Third-party marketers must tell you, in writing, they don’t offer every plan in your area.
If someone crosses one of these lines, you can report it — free — by calling
1-800-MEDICARE. These protections come from the official Medicare Marketing Guidelines maintained by CMS (cms.gov).
Report a violation · 1-800-MEDICARE
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theClearing
Medicare Education · joinclearing.com
Agent Accountability
Cheat Sheet · Page 3 of 3
Questions to ask — walk in with these
You’re entitled to a straight answer to every one. Check each as it’s answered.
Is my one-time Medigap window about to close if I choose this plan — and what’s the exact date?
How does your pay change if I pick an Advantage plan versus Original Medicare? I want to understand the math.
If I take this Advantage plan, what’s the exact date my guaranteed right to switch back to Medigap ends?
Does this contract reset each December 31 — and are my copays fixed for the year, or can they change?
Is my doctor actively contracted with this exact plan for the coming year — not just listed in a directory?
Do any of my medications need prior authorization or step therapy, and what tier are they on?
About The Clearing: a Medicare education platform. We don’t sell insurance, recommend or rank plans, enroll anyone, or earn commissions. Nothing here is financial, legal, or medical advice; figures reflect 2026 parameters — verify at Medicare.gov. For personalized help, contact a licensed SHIP counselor or a licensed independent broker. Free to print and share for personal, non-commercial use without alteration or removal of attribution. © 2026 The Clearing · Not affiliated with Medicare, CMS, SSA, or any government agency.
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