Find the Right Health Insurance Agent

Like any financial services professional, finding the right health insurance agent may be overwhelming. You may be used to having group health coverage through your employer and now find yourself without insurance and guidance. With group health coverage, the most challenging health care decisions you had to make were probably limited to one insurance company with one to two similar plans. However, the purchase of individual health plans is far more complex. It can be difficult to find someone to help explain the different types of plans that are available to you.

If you search for a health insurance plan online, you may have several different agents contact you. This may be slightly annoying, however it provides you with the opportunity to shop for the best policy and get different agent’s perspectives on different types of insurance plans. The health insurance agent’s responsibility is to help you determine your needs, explain the best plans to fit your needs, and help you choose the plan. It is important that your health insurance agent obtains the most accurate health information in order to be able to qualify you for health insurance. Make sure that you provide honest information, as incorrect information may lead to a delay in your coverage.

When choosing a health insurance agent it is important to check with your State Department of Insurance to make sure that the agent is licensed to sell health insurance products and is in good standing with the Department of Insurance. It is also a good idea to ask your prospective agent for references or testimonials from previous clients. Make sure that you feel comfortable with the agent before you decide to work with them.

You should have a basic understanding of health insurance terms or ask your insurance agent to clarify specific terms that you may not understand. See the terms listed below.

Deductible

The amount a customer pays toward covered expenses before the plan pays benefits.

Office Copay

Office Copay is a benefit that allows you to pay only a flat dollar amount for eligible in-network physician office visit services. This option may not be available with all plan types.

Coinsurance Percentage

Coinsurance percentage refers to the amount of covered expenses you pay after the deductible. You usually share the cost of covered expenses with the insurer. For example, a coinsurance percentage of 75% means that, after the deductible, the insurer pays 75% of covered expenses and you pay 25%.

Coinsurance Out-of-Pocket

Coinsurance is the percentage of covered expenses the plan pays after the deductible. After the Out-of-Pocket maximum is met, the plan pays 100% of covered expenses.

Lifetime Maximum

The amount of the total lifetime benefit of the policy per person covered by the policy.

Annual Maximum

The amount of benefit paid per person covered on the policy during the calendar year after the insured has satisfied all out-of-pocket expenses. This option may not be available with all plan types.