Should I Use an Insurance Agent to Buy a Health Plan?

Buying a health plan can be complicated. There are so many plans. So many decisions. So many choices.

That’s why it helps to have an expert on your side. That expert, called an insurance agent, broker or producer, plays a key role in helping people with the health insurance buying process. Still, there are several myths about insurance agents and their role. Let’s tackle some of the most common ones.

Myth: Insurance companies don’t care if an agent is qualified as long as the agent sells their products.
Fact: As a highly regulated industry, we are required by both state and federal laws to make sure agents who sell Blue Cross and Blue Shield of Texas (BCBSTX) plans are qualified to help consumers. BCBSTX requires agents and brokers who sell our plans to sign a contract. The contract ensures agents know our plans, sell them in an ethical way and meet our high standards for serving members.

Myth: It costs more to use an agent because you have to pay a commission.
Fact: The insurance company pays the commission. You will pay the same amount for your health plan whether you use an insurance agent or buy it yourself. The difference is an agent can save you hours of time wading through choices. An agent has the know how to help you decide which plan is right for you.

Myth: An insurance agent is nothing more than a middleman.
Fact: It’s true. Insurance agents are middlemen. But not in the way you think. They are far more than an unneeded extra step. Agents are key players who help customers make sense of a complex system. A good agent will spend time learning about the needs of you and your family, then look for a health plan that fits those needs and your budget. He or she will walk you through the benefits, application and enrollment process.

Myth: An insurance agent works for the insurance company, not for me.
Fact: Most insurance agents are independent contractors. They want to sell you a plan again next year to make sure they keep getting paid. The better the service they provide, the more likely you are to renew your health plan through that agent.

Myth: There is no benefit to using an agent.
Fact: Using an agent provides lots of benefits. An agent:

• Offers free help
• Serves you throughout the year
• Makes allowed changes to your plan for you
• Helps you choose the right plan
• Enrolls you in a plan
• Gives you access to a special BCBSTX customer service department
• Keeps up with changes to state and federal laws that affect health insurance plans
• Is licensed and must take classes to stay up to date on the industry

Myth: It’s easier to buy health insurance online.
Fact: That may be true if you’re buying a book or a coffee maker. But health insurance is a complex business with many choices. If you buy the wrong insurance plan, you can’t simply send it back. You could find out the hard way that the plan you chose doesn’t cover the care you need or include the doctor you want.

Myth: Anybody can be an insurance agent.
Fact: It takes a lot of education to become a qualified insurance agent or broker. They are licensed by the state department of insurance. In many cases, they must meet state, federal and professional requirements each year. They take classes and must pass licensing exams. Insurance agents who belong to the National Association of Health Underwriters also agree to a strict code of ethics. Many career insurance advisors complete college-level courses to get a professional designation, such as:

• Registered Health Underwriter (RHU)
• Health Insurance Associate (HIA)

Myth: Once the agent sells you a health plan, that’s the end of your relationship.
Fact: A good insurance agent knows that this is a long-term relationship. Selling you the plan you need at a price you can afford is just the first step. The agent also will:

• Check your health plan each year to make sure the plan and the price are still right for you.
• Help you make changes to your account. That includes things such as changing your contact information, adding or removing dependents, and ordering ID cards.
• Help you with insurance claims, services or regulations.
• Assess your needs each year and help you renew your current plan or find a new one.

Originally published 1/11/2016; Revised 2021, 2023