Medicare Agent in Cleveland, Ohio: A Cuyahoga County Guide

A Medicare agent in Cleveland costs you nothing to use: the insurance company pays the agent, and your premium is the same whether you enroll through an agent or on your own. A good one is licensed in Ohio, independent rather than tied to a single insurer, and knows which plans include the Cleveland doctors and hospitals you already use.

I am Steve Almeroth, an independent, licensed Medicare agent with MedStar Insurance Agency in Middleburg Heights. Most of my clients live in Cuyahoga County — Cleveland, Parma, Lakewood, Westlake, Strongsville, Berea, and the rest of the West Side and the suburbs. This page covers what I would want to know if I were choosing an agent here.

What does a Medicare agent actually do?

A Medicare agent helps you choose and enroll in coverage that sits alongside Medicare: Medicare Advantage plans, Medicare Supplement (Medigap) plans, and Part D drug plans. In practice that means:

• working out your enrollment dates, so you do not pay a late-enrollment penalty
• checking which plans include your doctors and hospitals
• running your prescriptions through each plan’s drug list to compare real costs
• submitting the application, and helping again when something goes wrong later

An agent does not enroll you in Part A or Part B. That happens through Social Security, at ssa.gov/medicare or 1-800-772-1213. An agent can walk you through it.

Agent, broker, or advisor — is there a difference?

All three words describe someone holding an Ohio insurance license. The difference that matters is captive versus independent:

• A captive agent works for one insurance company and can only show you that company’s plans.
• An independent agent, often called a broker, is appointed with several companies and can compare their plans side by side.

MedStar is independent. No agent offers every plan in every area, so ask any agent you talk to which companies they represent.

How much does a Medicare agent cost in Cleveland?

Nothing. Medicare agents are paid a commission by the insurance company when you enroll. Medicare Advantage and Part D premiums are set by the plan and approved by Medicare, and Medigap premiums are filed with the state, so the price is the same through an agent, through the company directly, or on Medicare.gov. If anyone asks you to pay a fee to enroll in a Medicare plan, walk away.

How to check that a Medicare agent is licensed in Ohio

The Ohio Department of Insurance publishes every licensed agent. Look up the agent’s name at insurance.ohio.gov before you share your Medicare number. My National Producer Number and Ohio license number are on my About page.

The Cleveland question: which hospitals are in the network?

In Cuyahoga County the question that decides most plan choices is about doctors, not premiums. Cleveland Clinic, University Hospitals, MetroHealth, and Southwest General each contract with Medicare Advantage plans separately, and those contracts can change from one year to the next.

• Medicare Advantage plans usually have networks. Before you choose one, confirm that your primary care doctor, your specialists, and the hospital you would want to go to are all in network for the coming year — not just this year.
• Original Medicare with a Medigap plan has no network. Any doctor or hospital that accepts Medicare accepts the coverage, which is why many people who see Cleveland Clinic or UH specialists choose it.
• Ohio has no Medigap “birthday rule.” Outside your six-month Medigap open enrollment period, a Medigap company in Ohio can usually ask health questions and decline you. Make that choice carefully the first time.

The Medigap vs Medicare Advantage in Ohio guide covers the trade-off in detail.

If you have Medicare and Ohio Medicaid

Many Cleveland residents qualify for both Medicare and Medicaid. If you do, you may be eligible for a Dual Special Needs Plan (D-SNP), which combines your Medicare coverage with extra benefits and coordinates with Medicaid. You may also qualify for Extra Help with drug costs or a Medicare Savings Program, which can pay your Part B premium.

Medicaid applications for Cuyahoga County residents go through Ohio Benefits or Cuyahoga Job and Family Services. Once your Medicaid is in place, I can help you compare the dual plans available at your address.

When to talk to a Medicare agent

• Turning 65: three to six months before your birthday month. See Turning 65 in Ohio.
• Retiring after 65: before your employer coverage ends. See Still Working at 65 in Ohio.
• Every fall: during the Annual Enrollment Period, October 15 – December 7, after your plan’s Annual Notice of Change arrives. See Annual Review (AEP) in Ohio.
• Any time something changes: you move, you lose coverage, or you qualify for Medicaid.

Free Medicare help in person in Cuyahoga County

• Library talks. I teach free Medicare 101 classes at Cuyahoga County Public Library branches, including Middleburg Heights and Strongsville. Nothing is sold at these classes. See upcoming dates.
• OSHIIP. Ohio’s free, unbiased Medicare counseling program, run by the Ohio Department of Insurance: 800-686-1578.
• Social Security. For Part A and Part B enrollment: 1-800-772-1213, or find your local office with the SSA office locator.

Talk to a Medicare agent in Cleveland

I do not charge, and there is no obligation to enroll in anything. Call, email, or book a time, and we can talk by phone or video — or come to one of the library talks.

Steve Almeroth · MedStar Insurance Agency · Middleburg Heights, OH · 440-622-2112 · steve@medstar.agency

Not sure of your dates yet? The free Medicare enrollment calculator gives you a personal timeline in about three minutes.

For questions about all of your options, including plans I do not offer, contact Medicare.gov, call 1-800-MEDICARE, or reach Ohio’s State Health Insurance Assistance Program (OSHIIP) at 800-686-1578.