Whether you are brand new to purchasing insurance through the Affordable Care Act (ACA) marketplace or are re-evaluating your options for the coming year, Indiana’s marketplace plans can be overwhelming to even the most experienced shopper. As the 2021 open enrollment period has officially started, it’s important to remember that government regulations and product options vary widely. The options range depending upon whether you’re shopping for individual or family coverage, age brackets, and whether the policy is for an individual or a business. Within each entity, the availability of products and benefits requires careful study. In order to choose the best health care plan specific to your needs and conditions, financial experts encourage consumers to seek specialized professional advice from qualified health insurance brokers.
CareSource, a nationally recognized nonprofit health plan, wants to help those seeking health insurance find the most fitting option at an affordable price point. Serving all 92 counties in Indiana, CareSource offers the lowest priced marketplace options for consumers. Steve Smitherman, president of CareSource’s Indiana market, has details to share about how brokers can help consumers choose the best health care plan.
What is a health insurance broker?
Health insurance brokers are trained professionals who hold a state-issued license that allow them to assist and advise individuals, families and businesses on insurance products and services to best meet their needs. According to Jeffery Fishback, president and CEO of Purchasing Alliance Solutions Inc., there are details in policies that require previous knowledge and background that brokers experience every day through customer feedback and provider information. Because of their wisdom of the marketplace’s product options, brokers operate independently of specific insurance companies.
For those investigating the best health insurance option, brokers offer their expertise and advocacy free of charge. Further, they serve as an all-year safety net for guidance on how best to use the benefits of the policy you purchase. They know the forms, the plans in the area, and they understand the large network that encompasses the marketplace universe. This specialized knowledge helps to ensure that the product you purchase does what you need and expect it to do.
How do they help?
When purchasing health insurance, working with a licensed broker is extremely valuable, saving consumers both time and money:
· Allow Quick Access to Support: Members will always have a designated advocate if they need support with claims payments, coverage eligibility, access to care and other issues—a service that cannot be found on the HealthCare.gov website.
· Give Personalized Recommendations: After taking an inventory of your specific needs, brokers determine the pros and cons of different plans at the most affordable price. This personalized advice helps select the right plan and coverage options.
· Provide Specialized Knowledge: Consumers are not expected to know and understand key health care terms, and brokers are there to help make sense of available options.
· Explain Subsidies. As of early 2019, 87% of the 10.6 million people who received coverage through the exchange qualified for premium subsidies. Steve Telander, broker manager and Medicare/ACA specialist for Quick Insured Brokerage, explains that if you lose your job or change your income during the fiscal year, brokers can make appeals on your behalf to increase or decrease your subsidies.
Given your unique needs and the variety of benefits, deductibles and copays, a broker can assist you in finding the product with the best value that will deliver the best result for you at the lowest price possible.
How to choose a broker
As more carriers enter Indiana’s marketplace, consumers have two choices: either do the research themselves or engage with a broker to better position themselves for future security. Hugh White, president of Aspire Benefits, believes a collaborative effort to navigate health insurance’s complexities delivers a better result for the consumer. With numerous broker options available, look to resources such as your state insurance commissioner’s website.
The biggest takeaway? Working with a health insurance broker is better than facing it alone, and there’s no extra cost to you. Why not engage an expert whose sole purpose is to know and help educate you on all the ins and outs of a complex and critically important decision?
Steve Smitherman is president of CareSource Indiana Market.