A Health Insurance Agent is a person who sells health insurance to individuals and groups. The job responsibilities of this person include helping clients choose the right plan for their specific needs, explaining policy details, assisting with claims and coverage issues, and providing continuing education. This position requires excellent interpersonal skills, as well as knowledge of the healthcare industry and insurance market.
Licensed agents also help consumers with complicated issues like determining subsidy eligibility and processing Medicaid applications. They can also provide personalized insight and recommendations that may not be available through a government-run exchange website or unlicensed navigator. And unlike some government-employed workers, licensed agents have undergone background checks.
In addition, health care agents can make sure a patient’s advance medical directive is carried out by acting as the patient’s proxy. This is an important document that lists a patient’s wishes for medical treatment in the event they are unable to speak for themselves. This can be done by completing a form, available online or at many providers’ offices and senior centers. It typically includes a list of preferred doctors, hospitals and other healthcare facilities, as well as any preferences for life-sustaining procedures. A patient can name any person, including a family member, close friend, minister, priest or rabbi as their agent. It is advisable to name one or two backups as well.
A health insurance agent can also help with planning for a future medical crisis. For example, if a patient has a chronic condition that can be controlled with medication, the agent can recommend a treatment plan to avoid costly hospital stays or inpatient rehabilitation. In some cases, the agent can even coordinate a home health aide or other services that can help keep patients in their homes longer and out of costly facilities.
It takes a lot of time and effort to compare different companies’ plans and prices, but a health insurance agent does this for their customers. This way, they can make sure their clients get the most out of their health insurance dollar.
Licensed agents can offer a full range of service, from helping consumers select a plan to assisting with claim issues or filing a complaint with a company. They can also assess a client’s needs each year and suggest a new plan or renewal. Unlike a broker, who typically earns a commission only when they sell a plan to a customer, licensed agents can work for several insurers and are paid a salary by their employers. They can therefore give unbiased advice about which plans are best for their clients. This can help save money, as agents can negotiate discounts and other benefits that wouldn’t be available otherwise. They also can offer plans not available through the government exchanges, such as private insurers or Medicare Advantage plans. This is particularly beneficial for older people who may have complex health conditions that require a specialist’s attention.