Not wise to process open enrollment alone

Thursday, December 6, 2018

It’s time to sign up for health insurance. Between Nov. 1 and Dec. 15, millions of Americans will head to Healthcare.gov or the online exchange in their state to shop for coverage for 2019.

Selecting the right health plan can be daunting. Patients have six weeks to evaluate dozens of plans, each with different networks, benefits, premiums and deductibles. If they fail to purchase a plan during this open enrollment period, they risk forgoing insurance entirely next year.

Choosing wisely could save consumers thousands of dollars and guarantee they get the care they need. To ensure that they choose wisely, they should consider consulting free, expert resources – particularly licensed, professional agents and brokers.

The plans available through the exchanges provide coverage for 10 essential health benefits, including primary care visits, substance abuse treatment and mental health care. Consumers with annual incomes below 400 percent of the poverty level – about $48,000 for an individual or $100,000 for a family of four – can receive subsidies from the federal government to help pay for coverage through the exchanges. Nearly 10 million Americans claimed such subsidies this year.

Those who do not qualify for subsidies may find better deals on comprehensive coverage outside the exchanges.

Regardless of what type of policy they choose, it’s critical that consumers choose something. Uninsured patients are twice as likely to struggle to pay their medical bills. And they’re less likely to receive preventative care for chronic health conditions – which is both dangerous and expensive. Lacking health insurance is also associated with higher mortality rates.

Picking through all those options can be difficult. Six in 10 Americans don’t feel confident in their ability to pick the right plan. Just 14 percent of Americans have a “pretty good” understanding of how much health insurance actually costs.

That’s where health insurance agents and brokers can help. They’re well-versed at identifying consumers’ coverage needs. They can guide individuals to the right carriers, coverage levels and plans at the best possible prices.

Agents and brokers are experts at what they do. Nearly 70 percent have 10 or more years of experience. They’re licensed by the states in which they do business. And they adhere to continuous education and professional development requirements as conditions of their licenses.

The job of an agent or broker doesn’t end once they’ve helped a consumer find the right plan. Many serve as advocates for their clients, resolving billing issues or claims disputes. More than seven in 10 agents spend “most” or “a lot of” their time explaining coverage to their clients.

Picking a health insurance plan can be among the most important decisions a person makes each year. Fortunately, consumers needn’t make those decisions alone.

Janet Trautwein is CEO of the National Association of Health Underwriters. For more information, visit www.agent-finder.org.

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