Make your insurance broker a translator, not a buyer

In the endless sea of ​​choices and complications of health insurance, navigating your own ship is harder than it seems. Especially when you get a new job, go on Medicare, or turn 26 and therefore can’t stay with your parents. Every shipper needs a broker – brokers are a great help in choosing a health plan, but they are best used as insurance translators rather than your buyer. Learn the ropes of health care plans from brokers, but don’t let them steal your decisions. Ask them to name what is in front of the crow’s nest while you control the wheel yourself.

You may hear people refer to broker and health care provider interchangeably. It is a major source of confusion for many patients. Health insurance agents have contracts to promote and sell only one company’s plans. While a company like United Healthcare has many plans under its umbrella, providers don’t have the incentives to provide you with alternatives that will serve you better. Brokers can join as many companies as they want. Most brokers settle on a certain level. For example, a broker can help patients enroll in Medicare. In any case, you don’t pay these people directly. Both types of health care consumers receive commissions from the insurance plans themselves. Although many independent businesses are choosing to be paid by insurance buyers, these businesses are often designed for larger clients.

The cost of selling a health plan is the biggest challenge in hiring a shopper, whether you are a patient or an employer. Companies encouraging brokers to offer other plans sounds good on the face of it, but there is room for improvement here. Insurance plans pay brokers and those commissions are reflected directly in insurance premiums. Then the employer (and, by extension, you) pays the premium. Agents who represent one insurance company also tend to get other bonuses. Even brokers with multiple plans may charge senior clients separately for special advice. A smart dealer offers plans with the highest bonus for them. This is a direct conflict of interest similar to the old days of pharmaceutical companies providing repeat drivers to doctors who prescribe certain drugs. Employers and patients may not know the cost of insurance unless they ask. So ask about the salary schedule of everyone you hire. Reviews of individual health plans are not the end-all-be-all, as many companies state that premiums are ‘representative.’ You only get the exact price once you complete the insurance process and write up. Knowing this bias will allow you to keep the broker as honest and not a scammer.

Whether a rookie or a master shopper is on your side, you need more than words. Because there are so many plan choices, your broker should do a side-by-side comparison. The duties of a health insurance buyer do not end after you purchase coverage. Agents should assist you with repairs and customer service as needed. If you’re getting a plan from a company like Aetna, make sure you get the information you need from an agent who can answer your billing questions and reviews. If all of this sounds complicated, that’s because there’s a reason brokers have a job. Buying insurance is confusing enough that most exchanges have people called navigators. These are like agents but they are paid by federal and state subsidies instead of insurance companies. Operators do not need to be licensed in a given area and cannot promote one health plan over another – they are like workers in a supermarket or hospital. Navigator is just another part of the health care explosion. It is better to have a professional but biased than a sailor. Better yet, use the internet. Use web solutions like health insurance company websites, broker platforms, and consumer contracts, so you don’t have to rely solely on your broker to comply with all the rules.

Source: eHealth

Even with the wrong incentives, brokers are helpful in navigating the foreign language of health insurance. Most Americans still don’t know what the deductible and out-of-pocket-max are. A broker can help you narrow down the gap in insurance coverage for you. Don’t rely too much on them – remember, they’re fighting for the health plan’s money, not yours. There is nothing to stop you from going it alone as long as you have a clear idea of ​​your needs. Ask yourself: how often do you have to go to doctors and specialists? How are you connected to your current supporters? Are you taking prescription medication? Are those drugs prescribed? Do you have a budget and want to add people to the insurance? Let your broker participate but not control the discussion about it. You are making your final health care plan more expensive by exchanging personalized advice. The important thing is that you know there is a tradeoff. Let this information be put before other patients and employers. Let them do their job if you choose a broker or agent. Take ideas in stride, but know that no one type of insurance can represent you. You or your employer decide which plan to use. The seller simply translates your options into plain English. Be specific and make sure that’s all your broker is doing.

Rushi Nagalla and co-founder of the practice of dermatology.

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