Get Your Benefits in Order

Get Your Benefits in Order: Why Talking to a Health Insurance Agent Is Worth It

Are you ready to set your health benefits up but need some help getting started? Here’s why you should sit down with a health insurance agent.

Have you ever been shocked by an explanation of benefits? Following a test or procedure, many Americans are stunned by the resulting medical bills.

The truth is that insurance holders often lack a full understanding of their plan’s coverage. In fact, 96 percent of Americans overestimate how much they know about health care plans.

For this reason, you should talk to a health insurance agent to get your benefits in order. An insurance professional will help you shop for a plan that fits your needs.

An agent will explain how health coverage works and what type of benefits you can expect to receive. Read on to learn why talking to a health insurance agent is worth it.


Deductibles are one of the primary reasons why people are surprised by medical bills. A deductible is a cost threshold that must be reached before the insurer starts making payments.

For example, consider a plan with a $1,000 deductible. In order for coinsurance to kick in, you need to incur $1,000 in out-of-pocket expenses. Anything that occurs prior to reaching $1,000 is the sole responsibility of the individual.

The average family deductible in the United States is nearly $8,000. A medical insurance agent can help you find plans with a more reasonable deductible.


Many people mistakenly believe that their payment responsibility ends with a biweekly or monthly premium. This may be true for some Cadillac plans. However, the vast majority of Americans have something called coinsurance.

Coinsurance means that the health insurer pays a pre-determined share of medical costs. In layman’s terms, the insurer and insured share the burden of medical costs.

Health insurance plans typically represent coinsurance as a percentage of the claim amount. For instance, the insurance company may pay 80 percent of a medical claim.

This percentage can vary based on the type of medical procedure or test. A medical insurance agent can help you find a plan where the insurer is responsible for the vast majority of allowable costs.

Searching for Insurance

Many Americans are lost if their employer does not offer health insurance. This is an area where medical insurance agents provide enormous value.

Insurance agents are experts in both the public and private health care market. They will review your income and inform whether you are eligible for any government health care programs.

If you are not eligible for a government plan, they can help you navigate the Covered California marketplace. Here, you can shop for a quality plan.

An agent will also determine whether you are eligible for any health care subsidies. This is funding that the government has made available to make health care more affordable. They will also inform you about open enrollment periods and when to submit an application.

Reach Out to a Health Insurance Agent Today

Understanding the health insurance market is not easy. With complex terms and conditions, the insured are often left scratching their heads.

The good news is that there are experienced professionals ready to help. If you want to speak with a health insurance agent, contact us today for help.

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