Finding A Health Insurance Agent.
Hopefully, this information can help you when shopping for health insurance. We are always available if you need us!
1. WORK WITH A HEALTH INSURANCE AGENT.
What is a Health Insurance Agent?
A health insurance agent, or sometimes called a health broker, is a sales person who is familiar with many insurance carriers and many policies.
How does a health insurance agent get paid?
An agent gets paid directly through the carrier, so there is ZERO cost to using a health insurance agent.
Can I get a policy for less by going directly through a carrier?
NO. All costs are the same.
Why do the carriers use health agents?
Agents are a way for carriers to efficiently market their products to the consumers. Costs can be controlled by paying agents a set commission. This allows the carrier to focus on managing their claims and helping its subscribers.
What does an agent do after I find a plan?
First the agent can assist you with the application and help make sense of the more difficult questions. An agent is also familiar with Underwriting Guidelines, so a health agent can tell you if a rate increase would be expected or not.
Are all agents good?
No. First make sure your agent is Licensed. Ask the person you are speaking with for their License number and check it with the Department of Insurance.
Second, see of your agent works with many carriers or only one. It's hard to get an unbiased opinion if the agent only represents one company.
2. BUY INSURANCE FROM A WELL KNOW CARRIER.
If someone took you to a car lot and offered to buy you any car on the lot, would you consider buying a car type you had never seen or heard of before? Probably not. A health insurance policy is the same way. If your agent is only offering one company and you have not heard of the carrier, chances are the policy may not be what you are looking for.
Why risk your health and money buying ABC & 123 Insurance when you could have a good well known company like Aetna, Anthem Blue Cross Blue Shield, Cigna, Humana, or UnitedHealthcare / UnitedHealthOne.
3. MAKE SURE YOU CAN AFFORD YOUR MONTHLY PREMIUM.
Sadly, most individual health insurance policies only last about 8 months. Some people find a job that offers insurance, but most quit paying there premium. Through years of experience we found that people who buy less expensive policies usually keep them longer. By working with a knowledgeable agent he or she can show you basic coverage that may not cover every office visit, but will still provide preventative care and hospital coverage. Often times people forget why they buy health insurance. It is not so much to pay $30 or $40 for an office visit, as it is mostly to protect your assets and to get medial coverage if needed. Imagine getting colon or breast cancer, or having your child come down with Leukemia, and you do not have proper medical coverage. Children have some hope of maybe getting treatment, but many adults will not get proper treatment and only find their life span drastically decreasing.
4. NEVER HAVE A LAPSE IN COVERAGE OVER 63 DAYS.
Any lapse in coverage is bad, but a lapse over 63 days is even worse. If you have over a 63 day lapse in coverage and you sign on to a new policy, you will most likely be subject to a six month contest period for any claims filed for a disease or illness. This law is different from state to state, but let's say in Nevada you have a 90 day gap in coverage and after you start a new individual policy you have a mammogram and discover you have breast cancer. If you have owned the policy less than six months, the carrier can contest the illness as pre-existing because you lack prior medical coverage. Now should you have prior medical coverage when starting a new policy the cancer treatment would be covered.
However, here is another example to help clarify the stipulations. Let's say you have a 90 day lapse in coverage and you get a new policy. The day the policy starts you fall down the stairs and are taken to the emergency room. This would be covered as there is no disputing the actual onset of the injury.
5. ONLY WORK WITH ONE AGENT
After you find an agent you like and trust. Only work with that agent. If that agent represents many carriers he or she can show you all the possible choices of coverage. On some occasions I've had clients sign up with a proven popular plan and soon cancel. When I make an inquiry into the cancellation I learn that the replacement policy, sold by another agent was not thoroughly explained. The client ended up buying something different than what they expected! Sadly, this all could have been prevented by just calling the original agent and asking about the coverage of the other plan in question. Remember, a good agent's ultimate goal is to get you a policy that you are happy with and keep for a long time.
6. I DO TAKE MEDICATIONS BUT I AM HEALTHY.
It is good to be optimistic but by underwriting standards, if you take medications you will not be approved at preferred status (excluding a few medications such as generic birth control, antibiotics). If you have a diagnosed condition, and you take medication for it, there is a good chance you will get an increase in premium. It may only be 0.5 mg of blood pressure medication, but by underwriting standards that is not preferred status. Remember if you are truly healthy that means your height and weight is good and you are not on ANY medications.
7. DON'T BE FOOLED BY AN AGENT SAYING: JOIN OUR ASSOCIATION AND YOU WILL GET A GROUP RATE.
NO. This is a sales pitch. You are only eligible for group insurance if you ARE a fulltime employee (and your employer offers health coverage) or if you own a company and you HAVE fulltime employees.
8. GROUP INSURANCE COSTS LESS.
NO. Usually, your employer pays most of the cost on group insurance. Remember group insurance is guaranteed issue, so all those very unhealthy people are guaranteed insurance and they drive up the cost of the coverage. Also, the coverage usually has a great deal of "bells and whistles." Group coverage usually has better chiropractic, acupuncture, and mental health coverage.
When we run quotes for small businesses (2+ employees) they usually opt out and chose to get individual insurance as the business owner finds it to be more affordable.
9. I NEED TO RESEARCH ALL THE PLANS I CAN FIND.
No. You need to research your agent. If you find a good health insurance agent he or she will have already researched the many possibilities and sifted through the garbage. And, even better, the agent will have heard years of feedback from his or her many health clients.
If you are looking for a grand spectacular deal, I promise, you will not find it in a health insurance policy. In my experience the people who really search out the miscellaneous carriers and find some unheard of plan end up not only having wasted their time but also having made a bad purchase.
10. I ONLY NEED TO FIND HEALTH INSURANCE FOR THE KIDS.
Unless you are in an extraordinary financial bind, this is a very poor idea. A better option would be getting a very high deductible plan that covers the whole family.
Ex: Husband and Wife are in their 40's and children are 8 and 10. The family could get an $8000 deductible plan with one physical a year for $180 a month or the children can get $500 deductible plan with unlimited office visits and dental for the same price.
Take The Family Coverage! An $8000 deductible may sound high now, but after your first $35,000 chemotherapy treatment, $8000 is a deal. Not only will you get the treatment that you need, but you will not have to cash in your 401K, sell your house and cars, just to try and get the treatment you need. Instead you just worry about the $8000 deductible and not the half million that the insurance company paid for your treatment.
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