What to Ask Insurance Salespeople When Buying a Medical Insurance Policy

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Feb 9, 2020

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The recent legal problems of insurance companies such as MEGA Life and Health Insurance Company, NASE, Midwest National Life Insurance Company of Tennessee, Alliance for Affordable Services and Health Markets have prompted consumers to make sure they are not only getting the kinds of coverages they are paying for, but the kinds of coverages they need.

In order to do this, it’s important to know what questions to ask the salesperson or agent prior to buying. According to experts, here are some questions that you should ask your potential provider:

  • What is the cost of the monthly premium, deductible, co-payment amount and cap? How does changing one amount affect the others?
  • What does the policy cover? What does it exclude? Are there limits on the number of days the insurance company will pay for services such as prescription drugs, maternity or out patient services?
  • Are pre-existing conditions covered?
  • Does coverage begin immediately or am I subject to a waiting period?
  • Is there a lifetime maximum cap the insurer will pay? This is important to know if you or someone in your family has a chronic or expensive illness or medical condition. Experts recommend that you choose a plan that has at least a $1 million maximum benefit.
  • How do I obtain emergency care? Can I use urgent care facilities without pre-approval? Am I limited to using certain facilities in the plan?
  • What else is covered? It’s important to find out if routine services, such as preventive care, immunizations and mammograms are covered under the policy.

A Stitch in Time…

It is better to get your questions answered up front instead of wondering if the amount and type of medical healthcare insurance you purchased will actually cover you when you need it. If you do decide to purchase the policy, make sure that all of the information you obtained is detailed in the policy.

Consumers should realize that many insurance salespeople are generally just that – salespeople. Unfortunately, many are more concerned with meeting quotas than they are about your personal well being. Part of what got MEGA and its partners in trouble was that their salespeople were never really informed about the products they were selling. Instead, they were taught how to sell and close the deal, leaving many policyholders without proper coverage.

If you need to find an attorney in your area to review your policy, or if you were a victim of one of the insurers listed in this article, click here to find an attorney who is a veteran in insurance matters.

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