5 Reasons You Need a Health Insurance Broker

It should be so simple – log in, look at the pretty products, pick one, pay and go about your merry way. But for most people, it’s anything but. The confusing terminology, the weird layouts, and how the heck do you know what you need, anyway? For the beginner – or the old timer that is seeing new things – a broker can make a world of difference, and may not cost you anything. Here are the top five reasons you need a broker:


Reason #1: I Have Special Needs

The Affordable Care Act (ACA) doesn’t guarantee the information you will be provided by your Marketplace. Most Marketplaces, and HealthCare.gov, strive to get you the best, most up-to-date information they can – but they do not guarantee it. So, you need Medicine X. The handy formulary (drug list) says the plan you want covers Medicine X – great. But that formulary is on the website and is not the insurance company’s formulary. So, you buy Plan Y and go to the drug store only to find that Medicine X isn’t covered – and now you are stuck with a plan that does not meet your needs.

Most medications don’t present this problem – but if you absolutely have to have a given medicine, especially if you’ve ever had trouble getting it covered, getting a broker will help insure that the plan you buy meets that need. Make sure to specify IN WRITING what your needs are before you agree to let your broker act for you or to buying whatever plan they propose. Most brokers are diligent and know how to correctly check on coverage limitations – but things go wrong for even the most diligent. By having everything in writing you have a much better chance of getting a correction if you do have to appeal to the Marketplace.

Reason #2: It’s All Greek to Me

Coinsurance is NOT the same thing as a copay – and can be a nasty surprise when all you want is to see the doctor. One size definitely does NOT fit all. If you’ve never had to navigate insurance policies before then a broker is a much safer bet. They speak insurance fluently – and once they understand your needs, they can find the plan that fits both your budget and your needs.

Reason #3: I’m in a Big Hurry

It’s NOT easy to change plans if you make a mistake – and if you are rushing the chances of making a mistake are much higher. This is a recipe for disaster you can easily avoid. A broker is going to make you slow down and explain what you need – then find that plan for you. You spend a little more time on the phone but you get what you need quickly with much less risk of it blowing up in your face later because you rushed the job.

Reason #4 My Needs Have Changed

Gotten older, new baby on the way, new diagnosis that will require treatment – any number of things can make your health insurance picture very different. The cheap plan that worked fine while you were in college may become a bad idea once you have a family. A broker can help you navigate the changing picture and find a plan that actually works for you. Your good money is going toward this thing – a broker can help you make sure your good money is paying for a good plan.

Reason #5: It’s Not Just Me

Dad moved in, oldest kid is away in college, the surprise baby is due, a step-kid is moving in – family is a wonderful but complicated picture and it can really complicate your insurance needs. A broker can save you money, time and frustration both during Open Enrollment and during Special Enrollment Periods brought on by a Qualified Life Change Event – such as your Dad transitioning to Medicare or that beautiful newborn.


Life likes to throw curve balls. Insurance should not be one of them. Play smart – get the professional help you need when you need it!



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