People often ask whether using an agent means paying extra. For most individual health plans it doesn't. Here's how it works, and what to ask before you choose someone to work with.
How agents get paid
Insurance companies pay agents a commission when you enroll through them. You don't send the agent a bill for a quote or advice.
Does the plan cost more with an agent?
For Marketplace plans, the monthly premium for a given plan is the same whether you enroll on your own or through an agent. Any premium help you qualify for works the same way too.
Private plans are priced by the carrier, and agent compensation is part of how carriers sell them. In practice you'll see the carrier's rate, so ask the agent to show you the monthly premium and total costs before you commit.
Independent vs. captive agents
A captive agent sells for one company. An independent agent can offer plans from several carriers. That's the difference that matters for you, because an independent agent can compare, and a captive agent can only show you one company's options. We're independent.
The honest caveat
Commissions can differ by carrier and plan, which is a reason to ask questions. A good agent will explain why they're recommending a plan, show you the alternatives, and tell you what each one doesn't cover.
Questions to ask any agent
- Which carriers can you quote, and which can't you?
- What will I pay each month, and what's the most I could pay in a year?
- Are my doctors and prescriptions covered?
- What's excluded or limited on this plan?
- Who do I call when I have a billing or claims problem later?
This article is general information, not a guarantee of coverage or pricing. Plan availability, benefits, and eligibility vary by state and individual. Some private plans are medically underwritten and do not include all ACA essential health benefits.