To find a licensed Medicare agent in Durham and Wake counties, verify the agent’s NC license at sbs.naic.org, choose an independent broker over a captive agent or call center, and confirm they know the actual carrier-to-Duke Health and UNC Health contracts in your zip code. Robert Simm — NC License #10447418 — represents every major carrier in North Carolina and meets clients in person across Durham and Wake counties. For your specific situation, call Rob Simm at (828) 761-3326 — free, no obligation.

What Durham & Wake families ask

What should I look for when choosing a Medicare agent in Durham or Wake County?

These are the four questions I hear most from Durham and Wake County residents looking for a Medicare agent.

How do I know they’re actually licensed?

Go to sbs.naic.org and search by name. Any legitimate agent gives you their NPN upfront. Robert Simm’s is #10447418. If an agent won’t share their license number, hang up.

Independent broker vs. captive agent — what’s the difference?

A captive agent sells one carrier’s plans. An independent broker compares every major carrier for your zip code, doctors, and medications. The cost to you is $0 either way — the carrier pays the commission.

Will they know if my Duke or UNC doctor is in-network?

A local broker verifies network contracts directly with each carrier — not just the online directory, which can be 6 months stale. This is the single biggest value of working with someone local to the Triangle.

What about those 1-800 call center “advisors”?

National call centers (eHealth, GoHealth, SelectQuote) get paid more to steer you toward certain carriers. You talk to a different agent every call. Several are under active DOJ investigation. A local independent broker works for you.

⚠️ Call-center agents don’t verify local networks

In Durham County, Duke Health is in-network on some MA-HMO plans in January and drops out by mid-year. A 1-800 agent won’t catch this — they read from a federal directory. A local broker calls the carrier and verifies the contract is locked through December 31 before you enroll. One wrong plan can cost you $5,000+ in out-of-network bills.

The difference

What’s the real difference between doing it alone and working with an independent NC broker?

What do you need to know?	Medicare.gov	Rob Simm — NC #10447418
Plans you can compare	Whatever’s listed, no NC context	Every major NC carrier, filtered to your situation
Durham/Wake network knowledge	Generic federal directories, often 6 months stale	Direct contract verification with Duke, UNC, WakeMed
2026 cost math for your budget	Generic rules — no IRMAA, no spousal coordination	Run with your real income and household
Part D formulary check	Manual entry per drug, per plan	Every prescription checked on every eligible plan
Same person next year	Different agent every call	Same broker, same phone number, every AEP
Cost to you	$0 (just your time and risk)	$0 — carrier pays the same commission regardless

2026 Medicare numbers

What are the key 2026 Medicare costs a Durham County resident should know?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

$9,350

MA in-network out-of-pocket max

2026 cap on in-network Medicare Advantage spending.

$2,100

Part D out-of-pocket cap

No catastrophic Rx costs in 2026. Insulin capped at $35/month.

💡 Broker Tip — Durham & Wake Counties

In Durham and Wake counties, Duke Health and UNC Health dominate the specialist landscape. Before you pick any Medicare Advantage plan, ask the broker to verify — with the carrier, not just the directory — that your specific Duke or UNC physicians are in-network through December 31, 2026. PPO plans give you the most flexibility if you see providers at both systems. I verify every contract before enrollment. Call (828) 761-3326.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · Durham County

What happens when you pick the wrong agent vs. the right one?

Call-center agent

$5,200+

A Durham resident enrolled through a 1-800 number in an MA-HMO that dropped Duke Cardiology mid-year. She needed a stress test — out-of-network. Between the specialist, imaging, and follow-up she paid $5,200 out of pocket on a plan that was supposed to cap at $0 copays in-network.

Independent local broker

Same resident, same health profile. A local broker who verified Duke’s contract through Dec 31 would have placed her on a PPO that keeps Duke in-network — or on Medigap Plan G where Duke acceptance is guaranteed. Total surprise bills: $0.

It pays to talk to the right broker

How much does it cost to work with a local Medicare broker?

It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.

Common questions

Frequently asked questions

How do I verify a Medicare agent is licensed in North Carolina?

Go to sbs.naic.org/solar-external-lookup, select North Carolina, and search by name or NPN. Robert Simm’s NC license number is #10447418. Any legitimate agent will give you their license number upfront.

Is there a fee to work with a Medicare broker in Durham County?

No. Medicare brokers are paid by the insurance carrier when you enroll, and the commission is identical regardless of which plan you choose. There is no cost to you for comparing plans, getting advice, or enrolling through a broker.

What is the difference between a captive agent and an independent broker?

A captive agent represents one insurance carrier and can only show you that carrier’s plans. An independent broker like Robert Simm represents every major carrier in NC and can compare all available options for your zip code, doctors, and medications. Call (828) 761-3326.

Can a Durham County broker help me if I also need ACA coverage?

Yes. Robert Simm is licensed for both Medicare and ACA plans in North Carolina. If you’re under 65, losing employer coverage, or have a spouse who needs ACA while you’re on Medicare, he can handle both. Call (828) 761-3326.

What happens during the first call with a Medicare broker?

A 10-minute conversation to understand your doctors, medications, and budget. No pressure, no SSN required, no commitment to enroll. You can call (828) 761-3326 or book at calendly.com/robert-generationhealth/new-meeting.

Related Medicare guides

Medicare Enrollment in NC – 2026 Guide Extra Help/LIS Eligibility NC 2026 Compare Medicare Advantage Plans in NC Extra Help / LIS in NC – 2026 Eligibility Guide Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Cheap Health Insurance Without Employer Coverage Free Medicare Quotes Online

Get help in nearby NC counties

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with Duke Health directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-04 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE (1-800-633-4227) for information on all of your options. GenerationHealth.me and Robert Simm are independent agents not affiliated with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent may contact you. Information on this page is for educational purposes only and should not be considered legal or financial advice. Plan availability, premiums, and benefits vary by location and carrier. © 2026 GenerationHealth.me