7 Confessions of a Health Insurance Agent
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I’ve been a health insurance agent since November 2017 and have spent my time since then working in a non-traditional profession. I surprised myself by really enjoying the work and been privileged enough to work with people who share my passion and moral compass. Not everyone I have worked with has been completely ethical and not everyone has been successful. Fortunately, the grind and natural frustrations of any job tend to weed out those that are not a right fit. Many of you have prejudices about health insurance agents, and some of them are true, some not. Here are 7 confessions from a real health insurance agent:
1. I have a LICENSE
It’s not incredibly hard to get a license (take a course, pass a test, get fingerprinted, etc). However, having a license means I have a responsibility to act in your best interests. And I am held accountable to make sure that I help you get the best plan available for your needs. Not everyone that sells health insurance is licensed; some are just salespeople. Not having a license means sometimes what you think you are signing up for isn’t what you get, and there is not much you can do about it.
2. Yes, I AM allowed to call you
All 50 of those people that called you in the past hour are allowed to call. You went online and looked up health insurance. One of those pages you clicked on wasn’t information, it was an ad, which took your info and sold it to ALL the different companies who are calling. Even if you were on a Do Not Call list before, when you put your info online, something on that page allows them to give your info to people like me. I know it bothers you to be interrupted – I don’t like getting spam calls either – but how else do I know you need my help?
3. Not all plans are created equal
Even between plans from the same company. There are good and bad United HealthCare plans; there are good plans from Blue Cross Blue Shield and lousy plans from Blue Cross Blue Shield. And there are companies who only offer bad plans. There are 2 different types of plans: 1) Guaranteed Issue Plans, which are Affordable Care Act plans, Group plans, Medicare, or Medicaid; basically, any plan that doesn’t ask any questions about your medical history. And 2) Underwritten plans, which are Private plans, Association plans, and most Short Term Medical (STM) plans. These plans do ask about your medical history and sometimes will not cover preexisting conditions. Worse, there are some that underwrite when they receive a medical bill or at time of claim. So, after you see a doctor, they find a reason not to pay it because you saw a doctor about a similar issue before.
4. You can find a plan online, but…
You really need to talk to an agent. I know you don’t want to (whine, whine), but most health insurance websites are actually ads. If you already know you need the Affordable Care Act Marketplace (aka Obamacare), go to www.HealthCare.gov or its sister website www.HealthSherpa.com which is A LOT easier to navigate. If you aren’t sure you need a Marketplace plan, you need to talk to an agent. Some agents are captive, meaning they can only make money on plans from one company, and others are non-captive, which means they have access to more plans. Even non-captive agents have their favorite companies and plans, though, but…
5. I have my biases.
I try not to, but I do. I started in this business because I felt scammed by an STM company that refused my claim because it was related to an injury that had not needed treatment for nearly 15 years. Now, every time someone says they have a plan from that company, or one similar, I try to talk them into a better plan. Those insurance companies are good at 2 things: getting people to sign up and finding reasons not to pay claims.
6. Some insurance plans are not insurance
Healthcare Sharing Ministries advertise themselves as an alternative to traditional health insurance but are not health insurance. They even say it on their websites: for instance, “Whether any member chooses to share the burden of your medical bills will be entirely voluntary. As such, [sharing ministries] should never be considered as a substitute for an insurance policy.” chministries.org
Fixed indemnity plans are technically insurance, but they are really supplemental insurance and are not meant to be stand-alone plans. In other words, they only really work with a high deductible/catastrophic plans. Having a Fixed Indemnity plan as your only plan, without an Out-of-Pocket Maximum is not enough. It leaves you open to uncapped medical bills.
7. I can’t help everyone
Sometimes the only plan that will work for you is the plan you are on, like an employer plan or the COBRA option if you are leaving a group plan. I know COBRA plans can be really expensive, but sometimes they are the only plan available. Even worse, sometimes there are no good options. I had a client who had been diagnosed with cancer in March and his Short-Term Medical plan expired in June. Open Enrollment (OEP) was not available to him because he hadn’t lost coverage due to a life event. He had to pay out of pocket for treatments during the 6 months he couldn’t get coverage. Also, there are cracks that some people fall through. Subsidies are available through the Marketplace, but there is a minimum income threshold. The idea behind this is that anyone under that income can get Medicaid but, in some states, you also have to either have a child under 18, be pregnant, or disabled. You might just have to pick the best bad option available.
Conclusions
Short Term Medical plans are not for everyone in every situation. But they are not meant to be. They can do a really good job for people in certain situations and for a certain period of time. Using them as they were meant to be used, they can be a very good option and save people from financial liability for major medical problems. In all cases, talk to a health coverage advisor before making a decision about your health coverage.
Want to know more about health insurance? Sign up for my monthly email here, email me at mharney@myhst.com, or text/call 507-407-4034.
This information is for educational purposes only. It is not medical advice. Always consult your doctor for appropriate examinations, treatment, testing, and care recommendations. Any third-party content is the responsibility of such third party. I do not endorse or guarantee the accuracy of any third-party content and is not responsible for such content. Your access to and use of this content is at your sole risk.
