If you are trying to purchase a health insurance policy, you could contact each insurance company’s sales department, one at a time, and get policy information and rates. You might just find this to be a long and painful process, even though here in Arizona, there are only around ten health insurance companies offering individual and family plans.
When you contact a carrier, such as Blue Cross or Cigna for example, the only plans that carrier is going to try to sell you are their own plans. You cannot purchase a United HealthCare plan from Blue Cross. And maybe a United HealthCare plan would have been a smarter plan for you, but you’ll never know that if you try to work directly with an insurance company.
A professional health insurance agent, on the other hand, may represent every health insurance company that offers plans in Arizona. A good agent will ask you many important questions before trying to steer you toward a certain health insurance company’s plan. For example, maybe you require maternity coverage. One of the health insurance companies offering plans here in Arizona has a wonderful plan that includes maternity benefits, and for a 28-year-old female the monthly premium is $591. A comparable plan from a competing insurance company is just $376. That’s $215 less than the first plan. No sales person who is an employee of the first company will recommend that you call the other company so you can save money – that employee will simply sell you their plan at $591 and you may never know you had better options.
Or perhaps you have certain pre-existing conditions, and you are taking an expensive medication every day. Most likely, if a health insurance company decides to issue a policy to you, they will place a waiver (sometimes called a rider) on that pre-existing condition, excluding the condition and the daily medication from your coverage. Let’s say this happens, and your monthly insurance premium is $250. If the cost of the medicine that you now have to pay for on your own is $150 each month, your actual out of pocket cost for your $250 health insurance is really $400 every month. But there is a large health insurance company in Arizona that almost always excludes whatever pre-existing health condition you may have, however this one company, and only this one company, WILL pay for your prescriptions even after they have waivered away your condition. A professional health insurance broker would know this fact, and try to convince you that going with that insurance company would probably be a smarter choice for you over a company that would not cover your medication.
Most all of the plans offered in Arizona utilize a network of doctors, hospitals and other providers that one must use in order to get the maximum benefit from one’s health plan. A professional health insurance broker will ask you if you need to maintain relationships with your current doctors, and will make sure that any plan you purchase through that broker will include your doctors. Some health insurance companies maintain networks of providers that are nationwide, while other insurance companies have small, localized networks. If you travel away from home, you need to be sure that you can see providers if you become ill. A good health insurance broker will ask you if you travel to be sure you get the plan that will work best for you in most circumstances.
Insurance brokers provide another service that could be important to you down the road. If you have a claim that, for one reason or another, your insurer refuses to pay, your broker should be able to provide you with easy-to-understand reasons why, and may be able to show you and your medical provider the correct steps to take to get the claim paid.
We’ll have more on this subject soon…
