Should You Use a Health Insurance Broker?
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You should use a health insurance broker if you want guidance and advice when shopping for coverage.
Health insurance brokers are licensed to help you shop for and buy health insurance coverage. Brokers can help you get quotes from several companies and guide you through the application and purchase process.
What is a health insurance broker?
A health insurance broker is an expert who can help you navigate the health insurance market.
Brokers can help you understand your health insurance options, research health insurance companies and find the right plan for you. Typically, you won't need to pay a fee to a broker. Usually, the companies they represent pay them a commission for each policy they sell.
Health insurance brokers are licensed and regulated by the states they work in. This helps ensure that their knowledge of the health insurance industry is current so they can assess which policy is the best option for each client.
Health insurance brokers typically work with people who don't have group health insurance through their employers. Brokers will often help you shop for plans on the federal marketplace or a state marketplace. They may also be able to help you apply for a policy directly with a health insurance company.
Brokers are also important for small businesses that provide health plans to their employees. Small business health insurance brokers can help these companies find a group plan to match the needs of the employees.
What does a health insurance broker do?
A health insurance broker helps you review your options and find the best health insurance coverage.
A broker will help you understand what you need in a health insurance plan. Then, they'll shop for a plan that fits your situation. Finally, a broker will help you fill out your health insurance application.
Offers guidance
One of the most important jobs of a health insurance broker is to help clients understand how health insurance works.
Health insurance is complex, and finding a plan on your own might feel overwhelming. A broker will listen to your situation and help you understand what kind of coverage is best. If you have questions about how health insurance works, a broker can offer expert advice and recommendations.
If you're a business owner, you may need to offer health insurance to your workers. You'll probably think about your company's resources and what kind of coverage is best for your employees. A business health insurance broker can help you find the right policy. They can also help you understand the rules of business health insurance, like which employees you need to cover.
Compares companies and plans
Some brokers have contracts with multiple insurance companies. This can make shopping for coverage easier since the broker can help you compare health insurance plans from different companies.
Once the health insurance broker understands your circumstances, they will research different companies and plans to find options that might work. The broker will then get quotes from different companies. You will review the options, and the broker will be there to answer any questions.
Some health insurance brokers only work with specific companies. This means you will only be able to get quotes and buy a policy from the companies the broker represents. Brokers might also be able to help you get coverage from the federal health insurance exchange or a state exchange.
Helps you apply for a policy
Once you have found a policy, a health insurance broker can help you apply for insurance.
Your broker will help you fill out an online application or a paper application. You'll need to have some information ready, like your name, address and financial information. A health insurance broker can help make sure the application is correct and complete.
It's especially important to have accurate income information since that impacts your eligibility for premium tax credits.
If you're buying a policy from a marketplace, you'll have to apply during open enrollment, which happens in the late fall and early winter. You can apply for health insurance outside of open enrollment if you qualify for a special enrollment period. There are several ways to qualify, including moving, losing coverage through your job or getting married.
If you're buying coverage directly from a company, you might be able to buy a policy at any time without qualifying for special enrollment, but it depends on the company's rules.
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Pros and cons of using a health insurance broker
Working with a health insurance broker is generally helpful, but there are potential drawbacks.
Pros | Cons |
|---|---|
| Helps you understand health insurance | May only work with certain companies |
| Makes getting multiple quotes easier | Other clients may cause a delay in service |
| Offers expert advice | Commission may create a conflict of interest |
| Services are typically free |
For example, health insurance brokers have more than one client, which means that it may take longer than you'd like to get quotes. Because brokers get commissions based on the policies they sell, it's also possible that they could suggest products that aren't right for you. Brokers are licensed and regulated, though, so you can report suspicious activity to your state's Department of Insurance.
How to find a health insurance broker
First, understand what you want from a health insurance policy and from a broker.
- Think about your needs: You may be able to find a health insurance broker that specializes in certain areas, like helping small businesses find coverage or finding plans for noncitizens.
- Consider how you want to communicate: If you want to meet with the broker in person, you'll probably need to find someone close to where you live. If you're comfortable talking by phone or email, you could use a broker that's farther away, as long as they are licensed to sell policies in your state.
- Talk to someone who has used a broker: If someone you know has used a broker before, it might be helpful to talk to them. They might be able to tell you how they chose their health insurance broker.
Once you know what you're looking for in a broker, you can start searching for brokers in your area.
- Use a search tool: HealthCare.gov offers a search tool that shows agents, brokers and health coverage assistance in your area.
- Contact your state's Department of Insurance: Brokers are regulated by each state's Department of Insurance. Your state's Department of Insurance may have a list of brokers. It might also have a search tool to find a health insurance broker near you.
- Call local agencies: Some brokers work in health insurance agencies. Call insurance agencies in your area to see if they have a health insurance broker in the office.
- Get a referral: If you know someone who has used a broker before, contact them to talk about their experience. You might find that their broker is also a good fit for you.
Be sure to ask potential brokers what kind of services they offer so you can make sure they're the right fit. Also ask about fees. You don't usually have to pay a health insurance broker, but it's smart to check before scheduling an appointment.
What is the difference between a health insurance agent and a broker?
A health insurance agent works for a single insurance company and only sells that company's products.
A health insurance broker can get quotes and policies from more than one company, although they still might be limited to companies they have a contract with. A health insurance broker works for you. Their job is to review the companies they represent and help you find the best policy.
While there is a difference between agents and brokers, the words are often used interchangeably. If you're looking for a health insurance broker, ask if they can get you quotes for more than one company. If they can, they're a health insurance broker.
Frequently asked questions
Should I use a health insurance broker?
You should use a health insurance broker if you need help figuring out what the best health insurance option is for you. If you have specific health care needs, or if you own a business and need a group policy, a broker could also be useful.
How can I find health insurance agents near me?
Using the HealthCare.gov search tool is one of the easiest ways to find a local health insurance broker. Your state's Department of Insurance may also be able to help you find health insurance brokers near you. You could also contact local agencies to see if they have a health insurance broker on staff.
What are the benefits of using a health insurance broker?
Health insurance brokers can get quotes for you, so it makes shopping for coverage and comparing plans to find the cheapest health insurance easier. Using a health insurance broker is generally free. Brokers also understand the details of health insurance and stay updated on the changes to the industry.
What are the disadvantages of using an insurance broker?
Because brokers work with multiple clients, it may take longer to get quotes than it would if you shopped on your own. Some brokers only work with certain insurance companies. This means you'll only get quotes from those companies, even if another insurance company has a better plan for you. It's also possible that brokers could recommend a plan that isn't right for you because they get a commission. If this happens, you should report the broker to your state's Department of Insurance.