Questions to Ask Your Agent
Buying insurance, even through a trusted agent, can be a complicated purchase. To help guide you through your purchase and help you understand what you’re getting before you sign on to an insurance plan, Vimo has created this reference guide. For more information about health insurance, you can visit our Tips and Advice center, which features clear, detailed guidance on purchasing health insurance.
Questions About the Agent’s Business/Background
- How long have you been a licensed insurance agent?
- Are you a captive agent, who represents insurance policies from just one company, or an independent broker, who sells policies from several companies?
- How large is your firm? How many clients do you currently have?
- Do you work at a call center or somewhere else?
General Insurance Plan Questions
- What sorts of policies do you sell? Do you sell major medical insurance, limited benefit plans, discount plans or some combination of these?
- Which of these types of policies will we be discussing today?
- What is your preferred company and policy? Why do you prefer these to other options?
- What are your views on high deductible health plans? How do you think they compare to other forms of major medical coverage?
- What are your views on mini-med plans?
- What are your views on discount medical plans?
Policy Specific Questions
- What is the plan deductible?
- What sorts of co-payment or co-insurance charges are there?
- Is there an annual, out-of-pocket maximum to limit my financial exposure?
- Are there any other benefit limits? For example, will this plan place a limit on daily hospital reimbursements?
- What is an average monthly premium for this plan?
- Why would you recommend this policy over others?
- What does this policy offer that cheaper policies do not?
- What does this policy lack that more expensive policies have?
- Can I use this plan with a health savings account?
- What sort of network will I be connected to? Will I have to see a primary care doctor before I can see a specialist?
- How soon after applying should I expect a response? When will coverage begin?
- Will this policy cover pre-existing medical conditions? If not, how long will this exclusion last?
- Does this policy cover pregnancy and related maternity costs?
- Will you be able to help me throughout the application and underwriting process? If a member of my family cannot qualify for coverage, or can only qualify at an increased rate, can you help me find a separate policy for that family member?
- Is this policy guaranteed renewable? In other words, can the insurer cancel my policy even if I am paying premiums regularly and on time?
Who is a Health Insurance Agent?
Learn MoreNeed Tips on Buying Health Insurance?
Visit the Tips and Advice CenterKey Insurance Terms
- Premium: A set fee, usually charged monthly, that you pay an insurer for a policy.
- Deductible: The amount of money you will have to pay out of pocket before your insurance begins to reimburse care, although some plans provide some reimbursement before the deductible.
- Co-Pay or Co-Payment: A set fee—such as $10 or $25—that you pay for medication or care.
- Co-Insurance: A set percentage of the total cost that you pay for medication or care.
- Network: A contracted group of doctors, hospitals and care providers who work with your insurance plan at lower rates.
- Out of pocket maximum: An annual limit on the amount of money you have to pay before your insurance covers all remaining costs. This limit does not include plan premiums.
Types of Plans
- Major Medical Insurance: Designed to provide protection against the financial costs of a serious illness or medical emergency, major medical coverage pays for some fraction of routine care but will pay for virtually all of the costs associated with major care.
- Limited Benefit/Mini-Med Plans: Aimed at providing first-dollar coverage, mini-med plans pay for some of the costs of routine care, typically without a deductible. They have strict limits on daily reimbursements, however, and as such, do not provide the security of major insurance.
- Discount Medical Plans: In exchange for small monthly premiums, discount medical plans connect members to a network of hospitals, doctors and pharmacists who have agreed to offer lower rates to plan members. Not insurance in any form, plan members pay for all services—at the discounted price—themselves.