Who can help me with health insurance?

Buying health insurance is complex, even more so with the advent of the Affordable Care Act (ACA). We should expect website glitches and some confusion in these opening months of implementation as it is a huge program bringing about dramatic social & financial change across the country. As long as you have completed your application by December 15, 2013, you will have coverage in place beginning January 1, 2014, there is no reason to fight the system until it is running smoothly.

There are several ways to buy your health insurance. If you do not believe you will qualify for a subsidy you can buy a plan off the exchange through an agent or through the company directly. If you believe there is any possibility of qualifying for a subsidy, you should use the exchange marketplace as this is the only way to be allowed that subsidy credit. In order to obtain the exchange plan, you can contact your state or federally run exchange directly, use a ‘Navigator,’ or a licensed health insurance agent.

How does anybody get paid to help?

Contacting your exchange connects you with people trained and paid through the exchange, it’s their job, but it is a brand new job and everyone is learning the ropes right now. Utilizing a Navigator means you are being guided by a person recently trained in the basics of Obamacare and they are being paid by government grants either an hourly or a lump sum amount. Neither of these people are able to offer you policy service once the policy is issued and in-force. Their jobs have not been designed to provide ongoing assistance to you, but rather to facilitate that initial policy purchase. As well-trained as some may be, very few Navigators or exchange marketplace service representatives will have any experience with how these health policies will function in your life and may not be able to assist you in discerning the plan differences as you endeavor to find the right plan for you.

If you choose a licensed health insurance agent, they are paid a small commission directly by the insurance company as a percentage of the monthly premium. The agent likely has years of experience dealing with the various issues that can arise over the course of using those health insurance benefits and that agent can assist you if problems arise, for example, advice on claims or banking issues. An insurance agent can advocate on your behalf with the insurance company.

For all three options, exchange, Navigator, and agent, the person is paid to assist you in signing up for health insurance, only the agent is going to be available for policy assistance over the life of your policy.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s