Do I Need a Health Insurance Agent?

If you are buying an Affordable Care Act medical insurance on the marketplace, you may be wondering whom to turn to for advice: a licensed health insurance agent can help.

Rachel P.

Published January 13, 2021

Healthcare coverage is an important part of most people’s financial and personal lives. Without proper training and information, the complicated aspects of health insurance can make it difficult to understand what you may need and why.

Having a health insurance agent eliminates these concerns.

A health insurance agent brings expertise

Health insurance agents are specially trained and have expert healthcare knowledge of different health insurance companies, and the plans and coverage they offer. They can explain plans in detail and help consumers determine whether you qualify for subsidies.

In addition, health insurance agents can give health plan recommendations based on your circumstances and help you make the best decision for you and your loved ones. As such, they act as an unbiased third party, rather than a company directly trying to sell to you.

A health insurance agent’s job does not just stop when you buy your policy; they can also help with claims, billing questions and act as intermediary between you and your chosen insurance company.

Finding the best coverage at the best price

While it is possible to buy health insurance online, it is not always easy.

If you are buying directly from a company, there might be provisional statements or other parts of the policy you do not see or do not understand. There is no check and balance system on certain sites, and it is hard to determine whether you are getting the best deal and coverage for your situation and preferences.

A health insurance agent eliminates this concern, and can help you understand, plan for, and purchase the appropriate coverage.

For example, it is often difficult to determine the optimal cost-sharing options for your family health and medical care needs. A higher deductible will lower the monthly premiums, but is it the right choice for you? Based on your past medical history and your situation, your agent can help you find the right coverage at the right price.

Even when you are buying from the marketplace, it is a good idea to have an agent by your side. Extra help in understanding the plans and how they will work for you might be needed beyond what the marketplace provides.

Find an agent before you need a new insurance

Remember that you cannot change or purchase a health plan outside of open enrollment without special circumstances, like a marriage, birth, and death, or switching jobs. It is not a good idea to wait for open enrollment to find a health insurance agent.

Despite it not being required, it is helpful to have agent who thinks about what decision is right for you, and if you want a health insurance agent’s services, it will be better to plan on working with him before the marketplace opens so you have time to get to know each other and understand the process. 

Find an agent you trust

When you work with an insurance agent, you can access someone who understands how your insurance policies work as part of your total financial picture. Whether your goals are for personal or health insurance, real estate, or to protect your loved ones, an agent should have your best interest at heart and that is something invaluable.

Check their years of experience, certifications and customer reviews, this is important… But there’s more.

Do you like the person? Does she seem to have your best interests at heart? You want to build a long-term relationship with your insurance agent: trust is a must. Your health insurance agent should spend time to listen to you and understand your needs and goals.

Choosing a good health insurance agent means you’ll get the proper type and amount of coverage from a reputable company at a great price, and the support you need in case of disaster.

If you do not know how to find an agent, start by reaching out to your friends, family, or neighbors. If they do not have recommendations, you can try online. Make sure you feel comfortable with your agent and come prepared with all your questions and concerns. Your agent should be happy to help you and answer all your questions!