Can I use a broker to sign up for Obamacare, and does it cost extra?
It costs you nothing. Here is how brokers are actually paid, what to expect, and what a broker cannot do.
Yes, and it costs you nothing. Marketplace premiums are filed with regulators and are identical whether you enroll on HealthCare.gov yourself, over the phone, or with a licensed agent.
There is no broker fee, no markup, and no version of the same plan that is cheaper if you avoid us.
How brokers are actually paid
By the insurance company, as a commission, after you enroll. It is built into the premium whether or not you use an agent, which is why declining to use one saves you nothing.
The honest disclosure: commissions vary between carriers. That is exactly why you should expect an agent to explain why a specific plan fits your doctors, your medications and your budget. If the reasoning is thin, ask harder questions.
What a broker should do for you
- Compare every carrier available at your address, not one
- Check your actual doctors against each plan's network
- Price your actual prescriptions on each formulary
- Work out whether you qualify for cost sharing reductions, and steer you to silver if so
- Handle the application, including the employer coverage questions people get wrong
- Answer the phone in March when a claim is denied
That last one is most of the value. Enrolling is the easy part. Having someone to call when something goes wrong is what you are actually getting.
What a broker cannot do
- Change your premium. It is filed and fixed.
- Change your subsidy. That is calculated from your household income and size.
- Get you coverage outside an enrollment window without a qualifying event.
- Promise you a specific dollar amount before seeing your household details.
If anyone promises you a specific subsidy figure before asking your household income and size, or claims to represent the government or HealthCare.gov, walk away. We are an independent agency, not a government office.
Brokers, navigators and assisters
A certified navigator or assister can help you complete the application at no cost, but is not permitted to recommend a specific plan. A licensed agent can recommend one. Both are legitimate; they do different jobs.
What to expect from us
Bring your income estimate, your household details, your doctors and your medication list. Expect about half an hour. We are independent, so we compare across the carriers available in South Texas rather than selling one.
Se habla español. See what the application involves and what to bring.
Common follow-up questions
Is it cheaper to enroll myself?
No. Premiums are identical whether you use HealthCare.gov, the call center or an agent.
How is the agent paid?
By the insurance carrier as a commission after enrollment. It is priced into the premium regardless of whether you use one.
Can an agent get me a bigger subsidy?
No. The subsidy is set by your household income and size. An agent can make sure it is calculated correctly, which is a different thing.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
Call (956) 687-3334Read next
ACA Marketplace open enrollment in McAllen: what to know before November
Health and ACA