In this blog post, we’ll discuss:
- The different types of professional help available: agents, brokers and online marketplaces and sellers
- What you can expect when you work with an insurance agent
- How much it costs to work with an agent
- How to find an insurance agent near you
It’s smart to thoroughly research your insurance options to find the best fit for the next year or more, and that can include working with a professional insurance agent. But what if you just need temporary coverage or want basic coverage quickly?
You may be able to qualify for a short term health insurance policy and obtain coverage as quickly as the day after you apply if you’re approved. These policies are available year-round, but it’s important to note that they are not ACA-qualifying plans, are not required to include coverage for essential health benefits, and are not guaranteed issue so you must qualify to enroll.
Find out how much a short term policy could cost you and compare plan options.
Get a Short Term Health Insurance Quote
What to do Before You Contact an Agent
Conversations with your insurance agent will be more productive – and you’re more likely to get the coverage you need – if you’re both speaking the same language. So while not required, it will be helpful to understand some of the basics of health insurance before you start speaking with professionals.
Here are some resources for learning the health insurance basics:
- What is health insurance and how does it work
- Basic health insurance terms glossary
- The out-of-pocket costs you need to consider when shopping plans: coinsurance, copay, deductible, and annual maximum
- More about health insurance deductibles
- Managed care plan networks (HMO, PPO, EPO, POS)
- All about the ACA metal levels
- Supplemental health insurance options like medical gap, critical illness and accident coverage, or hospital insurance to help with your major medical costs or gaps in your coverage
No matter how much research you’ve done, it doesn’t hurt to get an expert’s perspective. A licensed health insurance agent can guide you through the health insurance plan selection process, show you a variety of options and help you choose coverage that fits your healthcare needs and budget.
Call to speak with a licensed Health eDeals agent
What a Health Insurance Agent Does
Health insurance agents (and brokers) may perform a number of services, including:
- Helping you identify the health coverage you need and obtain the policy.
- Assisting you with claims and acting as an intermediary on your behalf with the insurance company in some instances.
- Operating in your best interest (required by law in many states).[0]
Health insurance agents must meet a number of qualifications to be able to sell insurance products, including:
- Being licensed in their state to distribute the type of insurance they’re selling.
- Adhering to regulations set forth by their state’s insurance department.[1]
- If selling ACA-qualifying plans on the public Exchange, they must have had training and signed an agreement with the Centers for Medicare and Medicaid Services (CMS)[2]
How Much Does it Cost to Work with an Agent?
You likely won’t pay your health insurance agent or broker anything, at least not directly. Most agents are paid when they collect a commission on the products they sold, usually from the premiums you pay.[3]
Licensed Agent or Broker – What’s the Difference?
A licensed health insurance agent represents one or several insurance companies.[4] An agent who represents one company is considered “captive,“ while those who represent multiple companies are known as “independent.”[5]
A health insurance broker works like an independent agent and sells more than one health insurance company’s products. Agents may work for brokers.[6]
The key difference that may be important to you is that a health insurance agent represents the insurance company while a broker represents you.[7]
Which one is right for you?
If you’re primarily concerned about cost
You may want to start with a broker. Because a broker represents you, he or she can help find the best prices for the coverage you need and help customize or bundle policies. Because they work for a range of insurers, they may have a broader knowledge base.[8]
If you want more options
A broker or independent insurance agent may be the way to go. Independent health insurance agencies work like insurance brokers in that they represent multiple insurance carriers, but they generally are not as large as brokers.[9]
If you need a little more expertise
Because captive health insurance agents represent just one carrier, they may have a more thorough knowledge of the products they represent, but may not be able to offer comparisons to other insurance providers’ products.[10]
If you’re just gathering information
Online insurance websites are a good first step. They offer easy access to an insurance agent and 24-7 online access to policy information.[11] Get tips on how to buy health insurance online.
During your research, you’ll likely find that ACA-qualifying major medical coverage is the most comprehensive since it includes the essential health benefits and is guaranteed-issue. However, it also comes with higher premiums if you don’t qualify for a subsidy.
And depending on the time of year, you may not be able to enroll until the next open enrollment period.
Do You Need Temporary Insurance or Coverage Outside of Open Enrollment?
If a major medical policy isn’t available to you right now or it doesn’t fit your needs or budget, it’s still a good idea to consider some level of coverage for unplanned illnesses or accidents, especially to help in situations that land you in the hospital or ER. Short term health insurance is one such non-ACA health insurance option.
Short term policies:
- Generally have lower premiums than major medical because plans include less coverage. Your costs will be based on the benefits level you select.
- Are not guaranteed issue (meaning they do not cover pre-existing conditions and you have to be approved by the carrier to enroll
- Are effective for a limited period of time, typically from 30 to 364 days depending on your state.
- Are available year-round in most states and are not subject to the annual open enrollment period.
Find short term health insurance plan options and costs available to you by getting a quote.
Get a Short Term Health Insurance Quote
Questions to Ask Your Insurance Agent
A good agent or broker will probably have a range of questions for you – about yourself, your family, your coverage needs and budget. But you should be prepared with questions, as well.[12]
- What can they tell you about the company(ies) they represent?
- How long have they been in business? Can they give you references?
- What types of plans do they offer?
- What fees do they charge (if they’re a broker)?
- Is your current healthcare provider included in the plan(s) offered?
- What will the monthly premiums be?
- What’s the deductible?
- What are the copayments?
- Can they help you with claims?
Where to Find a Local Agent or Broker
Get Referrals
When looking for a health insurance agent near you, you might start by asking friends and colleagues for referrals. You may also perform your own search using online tools.
Use Online Search Tools
Inputting the phrase “health insurance agents near me” into your preferred search engine will typically bring up results for agents and brokers in your area.
Search engines like Google use your computer or phone’s geographic coordinates to identify where you are (city, state, ZIP code) in order to return relevant results. You can then compare by star rating and read reviews.
Review sites like Yelp perform a similar function and may also be helpful in sourcing a professional agent in your area as you can filter by geographic location, rating and read reviews.
The Angie’s List website also has a section for health insurance agents.
Use Insurance Industry Tools
The National Association of Health Underwriters has a “Find an Agent” tool.[13]
Once you find a potential agent, you can contact the Insurance Bureau or the Insurance Board in your state to confirm they are licensed and have no complaints pending. You can also check the National Association of Insurance Commissioners website.
Look up insurance agents you’re planning to work with on the Better Business Bureau to see if there are any complaints filed against them.
Summary + Next Steps
Health insurance can be an important tool in your financial planning toolkit. The more you understand about the details, the better chance you have to make the right decision for you and your family. And a health insurance agent or broker can help.
When looking for a health insurance agent near you:
- Get referrals from colleagues and friends.
- Use online search and agent locator tools.
Or call (888) 855-6837 to speak to a licensed agent now to learn more about costs, eligibility and coverage options.
