Some people understand health insurance well enough to explain it to the rest of us. Better yet, you can actually use those people to help you find the right insurance for your situation. But a VIP service like that has to come with the matching price tag.
Surprisingly, you usually won’t pay anything extra for the help. Considering the price of everything else in healthcare, it’s a refreshing change. Here’s what you need to know.
What does a health insurance broker actually do?
A broker is a licensed professional who helps individuals and families compare health plans. Their job goes beyond just handing you a list of plans and wishing you good luck. They can explain costs and coverage, check provider networks, answer questions, and help with enrollment and renewals.
Now, don’t assume every broker works the same way as an agent. Some agents work with just one insurer, while brokers typically represent several. The terms are often used interchangeably, so it’s worth asking who someone actually represents.
You aren’t required to use a broker. You can absolutely shop on your own if you don’t mind spending your free time comparing deductibles.
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So, who’s paying for this?
Usually, the insurance company pays its brokers commissions when customers enroll in plans. If you use a broker to enroll in Marketplace coverage, you won’t pay an additional fee.
Some brokers who provide services outside of the Marketplace may charge separate fees, depending on their services and state rules. So, if you’re looking beyond the Marketplace, make sure to ask about any broker fees upfront.
It all sounds pretty great so far, but there is a trade-off. Brokers usually show plans only from the insurers they represent. So while you’re getting professional guidance, you might not be seeing every available option.
Using a broker seems like a no-brainer, but is it actually the right move for you?
Should you use a broker?
Consider working with a broker if:
- You’ve compared so many plans that they’re all starting to look alike.
- You’re short on time.
- You need someone to explain your options and what you’re buying.
Before working with a broker, always ask which companies they represent, how they’re compensated, and whether they’re licensed in your state.
If you qualify for Marketplace premium tax credits, make sure you enroll through the Marketplace or a certified enrollment partner to receive those savings. You can also find free enrollment assistance through HealthCare.gov. Just keep in mind that a broker can handle some of the homework, but you’re the one who has to live with the plan.
