Finding the Best Health Insurance

December 17, 2013

Covered California, is one of the state health insurance exchanges that have recently been launched to serve as health insurance marketplaces under the Affordable Care Act. It is considered to be one of the more better, more accessible exchanges. Nevertheless, as many will attest, it is, nonetheless, an arduous experience to get through the application and enrollment process. Considering the amount of time and frustration needed to complete an application and chose a health plan, there are many who will, instead, pay the mandated fine for not having health insurance and hope for the best. A much wiser alternative for anyone shopping for health insurance is to work with a certified licensed health insurance agent.

Only Licensed Health Insurance Agents are Lawfully Qualified to Advise Buyers

Unlike the Covered California enrollment counselors available through the exchange, licensed health insurance agents are the only ones lawfully qualified to advise health insurance buyers of the best plans available for them both on and off the exchange. As a certified Covered California agent as well as a licensed health insurance agent, they’re also able to guide people through the subsidy qualification process as well as the insurance enrollment procedure; and there is no extra fee for their services. As the federal deadline looms closer, working with a certified licensed health insurance agent has other advantages as well.

Over 7000 licensed health insurance agents have been certified by the Covered California exchange to help applicants determine if they qualify for subsides and guide them through the application process. Licensed health insurance agents are trained to advise people in choosing the best plan for their family’s health conditions, life style and finances. Agents must also maintain their license by undergoing continuous mandatory instruction. Equally important, given the amount of personal information required of applicants, it’s significant that no one can become an agent without undergoing rigorous background checks and training in security and the  proper procedures designed to protect the privacy of their clients.

Availability of Enrollment Counselors

Enrollment counselors, available through the exchange, are paid $58 for each person they help enroll in Covered California. They’re temporary workers whose job essentially ends when the 2014 enrollment period officially ends next March.  They’re not experts in health insurance. They have just a text book understanding of health insurance terms like co-pays, coinsurance, deductibles, HMO, PPO, PPP. etc. This is language that health insurance agents use every day. They have an intimate understanding of  how these terms affect their clients in real life situations.

The biggest hurdle of Covered California’s applicants right now is the wait time to get help through the Covered California counselors. Thirty-six minutes is the current average and it’s going to get worse as health insurance deadlines approach. December 23 is the last day people can complete the purchase process for heath coverage to start January 1, 2014 and  March 31 is the last day to enroll for health care coverage in 2014. Unless there’s a qualifying life event, people who don’t enroll by March 31 must pay a fine and cannot apply for 2015 coverage until November 15, 2014. It’s estimated as many as five million people will want to apply between now and these deadlines.  Calling a certified licensed health insurance agent at California Health Plans, 1-866-657-8222, can begin the process.

Most people who need health insurance will not qualify for subsides. While Covered California is the only place to get subsidies, it’s not the only place to go for health insurance. This gives  people who don’t qualify for subsidies an even better reason to look to an agent for health insurance. That’s because, depending on the area, there are other health care plans available off the exchange.

Health Plans are Available Both On and Off the Exchange

All plans sold to individuals on or off the exchange have the same health care benefits.  Plans on the exchange are grouped into bronze, silver, gold, or platinum categories which cover, respectively, 60, 70, 80, and 90% of the plan holders medical expenses. Plans sold off the exchange are said to be “mirrored” if there’s plan identical to it offered on the exchange. “Non-mirrored” plans have no counterpart on the exchange and can cover different percentages of medical costs.

They also have another important advantage. To keep costs down, many of the plans on the exchange reimburse medical providers at lower rates. As a result, fewer medical providers will accept these insurance plans. Many plans available off the exchange have larger networks of medical providers, doctors, hospitals, clinics and labs, that might better serve an applicant’s medical needs. It means that certified licensed insurance agents often have more health insurance options available to offer applicants, options that may better fit their needs than are available on the exchange.

Health Plans Can Change From Year to Year

Maybe the best reason for going with an agent to purchase health insurance is that an insurance agent is someone who is not only uniquely qualified to help you chose the right plans, they are there for you. Buying health insurance is not a one-shot deal. The truth is every year, you’ll need to check your insurance plan. It may change or your needs may change; and other plans may become available that better suit your needs. Partnering with a licensed certified health insurance agent this year is a relationship for the future as well.


Post author Carole Spinak