Navigating health insurance can be confusing and time-consuming for many people. Fortunately, there’s a way that you can make it easier. Health insurance agents can help you understand your health insurance options. They can also provide personalized suggestions to help you find the right policy. Here’s what you need to know about health insurance agents and how to find one.
What Does a Health Insurance Agent Do?
A health insurance agent helps people enroll in health insurance plans. They typically work for a single health insurance company and are licensed in the state they work in. Health insurance agents provide their services at no charge to consumers; they make their money through commissions paid by the health insurance companies.
What’s the Difference Between a Health Insurance Agent and a Broker?
There are both health insurance agents and brokers, and the terms shouldn’t be used interchangeably.
Health insurance agents usually work with a single insurance company and only sell plans from that company. They can help you purchase traditional health care coverage plans or a Medicare plan. Some health insurance agents may also offer specialty insurance such as vision or dental plans. Then there are other insurance agents who can offer other types of insurance, including life and auto insurance.
Health insurance brokers, on the other hand, specialize in health insurance plans for businesses. As an individual consumer, you probably would never have an interaction with a health insurance broker. Business owners can work with brokers to pick health insurance plans that are right for the business’ employees.
Where Can You Find a Health Insurance Agent?
If you’re interested in working with a health insurance agent, there are a few ways to find one. First, ask your friends and family members if there is a health insurance agent that they recommend. You can also ask your employer if it has an insurance agent that you can work with.
When searching for a health insurance agent, location is important. It’s not necessary for your agent to live nearby, but they do need to be licensed in your state. If your circle of family and friends don’t have an agent to recommend, you can use HealthCare.gov’s tool to find a local agent.
What to Ask a Health Insurance Agent
If you’re going to use a health insurance agent when shopping for a plan, it’s a good idea to come prepared with a few questions. These questions can help you get a better understanding of what the agent can offer you before you enroll in a health insurance plan.
Which providers do you work with: Since health insurance agents usually only work with one insurance company, it’s important to know what company they work for upfront. No matter how much you like the agent, you need to make sure that you can trust the health insurance company with your insurance plan. You might want to consider the company’s financial ratings and customer service ratings. If you already have doctors that you want to continue to see, you should also make sure that the doctor accepts the company’s insurance plans.
How do you help me save money: It’s important to talk to health insurance agents about money, too. First, you’ll want to make sure that you understand how they will get paid for helping you. The agent should be getting paid a commission from the company whose plan you buy. You can also ask the insurance agent how they can help you save money on health insurance. While working with an agent can’t get you cheaper rates on health insurance, agents can help you pick a plan that works best for your budget. If the agent enrolls you in a plan through the Health Insurance Marketplace, they can also help you get premium tax credits and other savings if you qualify for them.
What types of policies are available: No matter what company the health insurance agent works for, there should be a few types of policies to choose from. The agent can help you understand the differences between the types of policies. You’ll want to specifically ask about the insurance premium, deductible and out-of-pocket costs. If you’re interested in using alternative medicine practices or want to ensure that a certain procedure is covered, you should let your agent know that as well. The agent can use this information to present the best policies for your needs.
Do you assist with claims: While you’re shopping for a plan, you should ask your agent what kind of support they can provide after they’ve helped you enroll in a plan. Health insurance agents can typically continue to assist you after the policy is purchased. Agents can usually help if you have questions or problems with your medical claims and/or appeals.
How often can I change my policy: Another thing that your agent should be able to help with is understanding how often you can change your health insurance policy. If your agent helps you purchase a plan through the Marketplace, you’ll only be able to change your plan for two reasons. There is an Open Enrollment Period each year at the end of the year during which anyone can shop for and purchase a new health insurance plan. There is also a Special Enrollment Period. You can only change your plan during a Special Enrollment Period if you have a qualifying life event. Some examples of qualifying life events are getting married, having a baby and losing your current health insurance coverage because of job loss.
Compare Health Insurance
When it comes to shopping for health insurance, you should compare plans even if you’re using an insurance agent. You can start the process on your own by using resources such as the ones offered by Benzinga. The Benzinga team provides insights and reviews on all the top health insurance companies to help you understand your options so you can choose the best plan available.
- Best For:Nationwide coveragesecurely through Blue Cross Blue Shield Health Insurance's website
- Best For:No enrollment period health insurancesecurely through Sidecar Health Access Plan's website
Plans referred to above are excepted benefit fixed indemnity insurance products marketed and administered by Sidecar Health Insurance Solutions, LLC and underwritten by Sirius America Insurance Company or United States Fire Insurance Company, depending on the state. As an excepted benefit plan, it does not provide comprehensive/major medical expenses coverage, minimum essential coverage, or essential health benefits. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such an excepted benefit fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. Coverage and plan options may vary or may not be available in all states.
When to Use a Health Insurance Agent
Benzinga is here for you with updated information about health insurance and other topics. But if you want more personalized assistance in choosing your health insurance plan, it might be worth talking to a health insurance agent. Be sure to return to Benzinga for the latest information and reviews to help you get on the right track.
Frequently Asked Questions
Is it cheaper to get health insurance through an agent?
Strictly speaking, no. You won’t get a cheaper health insurance rate by purchasing your policy through an agent. However, working with an agent can help you save money on your health insurance plan in other ways. For example, a health insurance agent can help you better understand your policy options so you can choose the right amount of coverage for your needs.
What do insurance agents need to know?
To help you find the best health insurance policy, it’s important for your insurance agent to know some key pieces of information. They’ll need to know exactly who you need coverage for, whether the policy is just for yourself or if you need coverage for a spouse and children as well. You should also be open and honest with them about what you want and need out of your plan. If you’re only looking for coverage that will help out if you face high medical bills in an emergency situation, the health insurance agent might recommend a plan with a lower premium and higher deductible. But if you visit the doctor frequently to manage certain medical conditions, your agent might recommend a plan with a lower deductible so you can reduce your out-of-pocket expenses.
What's the difference between an insurance broker and a navigator?
The main difference between an insurance broker and a navigator is their role and responsibilities. Insurance broker is an insurance professional work on behalf of clients to find and negotiate insurance policies, while a navigator is typically a representative from a government organization or nonprofit organization who helps individuals understand and enroll in healthcare plans, particularly in the context of the Affordable Care Act. Insurance brokers have a broader focus on different insurance types, while navigators primarily assist with healthcare insurance enrollment within specific government programs or regulations.
About Ashley Hart
Ashley Hart is a personal finance writer passionate about helping people feel empowered to take control of their finances. She has more than eight years of writing experience, focused on insurance.