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Small Business Employee Benefits and HR Blog

How to Get Advice When Buying Individual Health Insurance

Understanding health insurance options and purchasing an individual health insurance plan can be confusing at first, even scary. How can you get advice when buying an individual health insurance plan?How to Get Advice When Buying Individual Health Insurance

Here are four resources to learn about coverage options and get help with buying an individual ("personal") health insurance plan.

1) A Health Insurance Agent 

A health insurance agent ("producer") is one of the best resources for health insurance information, as he or she is a licensed professional who should understand all of the coverage options and help you navigate choices. A few tips:

  • You can check your agent's license with the State Department of Insurance to determine if he or she is in good standing (see #4 below).

  • A licensed health insurance agent is required to meet ongoing continuing education requirements set by the state to ensure he or she is up to date with the constantly changing health insurance marketplace.

  • A great way to find a health insurance agent is to ask family or friends. Or, your workplace may have an agent available to help you.

2) Your State's Health Insurance Marketplace

Your state's Health Insurance Marketplace (ex: HealthCare.gov) is another resource to learn about health plan options.

Go to your state's Health Insurance Marketplace website to find information, FAQs, and a glossary on health care terms. Each Marketplace also has direct help like call centers and Navigators. 

3) Your Company's Benefit Provider

If you work for a company that offers a reimbursement program for your individual health insurance premiums (such as a Defined Contribution Health Plan, an HRA, or a Reimbursement Plan), you likely have access to either a designated health insurance broker, or a health insurance concierge service. 

Log in to your employee account to find health insurance help, check your welocme packet, or ask your employer. 

4) Your State's Department of Insurance (DOI)

Insurance is regulated at a state level. As such, there is a separate Department of Insurance (DOI) in each state. In addition to regulatory matters, the DOI often provides valuable information for consumers, explaining the health insurance industry. Consumers can look to the DOI both when researching coverage as well as dealing with any claims issues. The DOI agencies regulate health insurance companies and insurance brokers and take disciplinary action on behalf of consumers if necessary.

The National Association of Insurance Commissioners provides a good map of the country with a link to each state’s insurance department website.

And...

Here are a few related resources to help you understand buying individual health insurance:

What is your advice about purchasing individual health insurance? What resources should be on this list?

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