10 Questions To Ask Your Health Insurance Broker

As the deadline of Open Enrollment quickly approaches, finding health insurance can be stressful. If you have never found your own health insurance before, working with a health insurance broker in your area can make the process easy. Broker’s services are free and they are a resource to help navigate the health insurance system.

Here are the top questions to ask your broker when you meet with them:

What does the application process look like?

Being prepared for the application process will allow you to plan for making your decision. If you know the application process will take a few days, then it is important to enroll as soon as possible. Enrolling right at the deadline can risk your application not being processed in time.

Do I qualify for any savings?

You may be eligible for extra savings or subsidies based on your income at the time of application. Be sure to have your income information ready with you at the time of application so you can see if you qualify.

Is my doctor in-network?

If you have a doctor that you care about, don’t forget to ask if they are covered under the plan you are looking for. Skipping this step can lead to high out-of-pocket costs because they are out of network, and there is no way to switch plans once you enroll.

What is my out-of-pocket responsibility?

Often, the focus is on the deductible, but instead, you should focus on understanding the max out of pocket. This is the total amount of money you have to pay before the insurance will pay anything at 100%. Although a deductible is important, insurance companies often only start paying a percentage of costs once this is reached. Getting your insurance to pay for all expenses at 100% won’t happen until you reach your max out of pocket, so it is important to understand what that will look like.

Is there any way to lower the cost without sacrificing quality?

When shopping for health insurance, you will likely be shocked at the cost in both the monthly premium and the max out of pocket. However, opting for a cheaper plan or no insurance at all will often get you what you pay for: large bills and limited coverage. Instead, ask your broker if there is another way to lower the cost while still maintaining a high quality of the plan.

When does this plan start?

Sometimes, the plan you are interested in may not start until the first of the next month. It is not common to find health insurance plans that start within 24 hours. Confirm with your broker so you can be prepared to make your first month’s payment.

How can I reach you?

Your broker should provide you with their contact information so you can always reach them including an email, phone number, address, or website address. If you are not able to reach them, it is likely that they are not offering you certified services.

How do I make payments?

Payments are made directly to your carrier. If your broker is collecting premium payments at the time of the meeting, be sure to understand which carrier the payment is going to and how you can get a refund if you change your mind.

When can I enroll?

Open Enrollment (November 1- December 15) is the only time of year you can enroll in a plan without restrictions. Any enrollments processed outside of Open Enrollment may ask to show proof you lost coverage within the last 60 days. Without this proof, you have to wait until Open Enrollment to apply. It is important to check with your broker to make sure you didn’t miss any deadlines. You may be eligible to enroll now. 

Do I pay you for your services?

No! Broker services are free, so if a broker tells you to pay for their services, it is likely they are not being honest with you about what they can offer.

Whether this is your first time using a broker or you already have a relationship with a broker, asking these questions can help you understand your health insurance benefits and get the most out of the services a broker provides. Don’t be afraid to ask a question–brokers are here to help!