Frustrated with Your Health Insurance Broker? Here’s How to Switch

There may come a time when you need to switch health insurance brokers.

Having health insurance in Mexico is essential for expats, so it is important to work with a broker you can trust.

Your health insurance broker should be your advocate and have your best interests at heart.

If you second guess this at any time, you should switch health insurance brokers.

Read on for what you need to do to switch health insurance brokers while living abroad.

What to Expect from Your International Health Insurance Broker

First things first…

Your broker is not legally bound to offer additional support.

There are even some international health insurance brokers who don’t even know how to help with pre-certification.

That doesn’t mean you shouldn’t have certain expectations of your broker.

Here are some things you should expect from your international health insurance broker:

• • They should be able to answer your questions in a timely manner – typically within 24 hours or as soon as possible if you have an emergency.
    
  • If they cannot help you after hours or over the weekend, they should at least have a backup contact or instructions for contacting the insurance company so you aren’t scrambling in an emergency.
    
  • Ideally, your broker will willingly give you their emergency contact information. They are not legally required to do so, but a good broker will.
    
  • They should be able to explain your policy to you accurately and professionally.
  • They should communicate and mediate with the insurance company when necessary.
    
  • They should communicate with medical providers when you need help getting paperwork. For example, if you are having a hard time getting the factura because the hospital administration is not being helpful, you should be able to reach out to your insurance broker for assistance. Your insurance broker should be able to speak with the hospital administration to explain what you don’t have (and aren’t required to have as an expat) so you can get the factura as needed. Again, this is not a requirement, but a good client service that you want in your broker.
    
  • They should be willing and able to suggest local resources. While they cannot, by law, endorse one specific doctor over another, they can make suggestions based on their previous clients’ experiences. They should also be able to suggest labs, quicker and easier direct pay facilities, etc.
    
  • They should keep you up to date about policy changes and rate increases.
    
  • They should be able to help with claims and pre-certification needs, including acting as a communicator between you and the insurance company, following up with pending requests from the insurer, and helping obtain pending documents.
  • They should have a system to stay on top of pending claims and pre-certifications, and keep you up to date.

Reasons Expats Want to Switch Health Insurance Brokers

Unfortunately, expectations are not regulations.

While you can expect your health insurance broker to always act with your best interests at heart as your advocate, that is not always the case.

The 2 biggest reasons why expats switch health insurance brokers are…

1. Clients feel like they were not given all the correct information when they purchased the policy, such as being sold a false bill of goods, the policy was exaggerated, or key information was omitted. This is typically discovered when a client must file a claim and realizes the broker misled them.
2. Clients feel as if they are not receiving enough support from their broker. For example, clients may need help with claims or pre-certifications. When they reach out to their brokers, the brokers never respond.

Health Insurance Brokers Can Refuse to Help You

Health insurance brokers can refuse to help you. They are not required to provide additional support.

This is why it is so important to find a supportive and responsive broker.

Rules for Changing Health Insurance Brokers

You can switch health insurance brokers at any time – and no reason is necessary to do so.

It doesn’t have to be awkward.

You don’t even have to talk to your current broker.

There are 2 different options for switching health insurance brokers.

Option A: Reach out to the insurance company and state whom you want to work with.

For this option, you will contact the insurance company directly and provide in writing that you want to change brokers. But you don’t have to say why.

If you have another broker in mind, you can request this individual, but you must state this in your letter.

If you don’t have a broker in mind, the insurance company will contact brokers for you.

Option B: Reach out to the broker you want to work with; they can help you.

What Happens If You Want to Change Your Health Insurance Broker Mid-Policy 

You can switch health insurance brokers mid-policy.

However, you may have difficulty finding a new broker if you are in the middle of a claim, disputing a claim, or in the pre-certification process.

This requires a lot of work, and the new broker will not receive any commissions from you as a client for the first 2 years.

This is because your previous health insurance broker will continue to receive commissions for two years.

How to Switch Health Insurance Brokers If You Have an Issue

Here’s how to switch health insurance brokers if you have an issue with yours.

1. Try to contact your broker directly to schedule a meeting to discuss the issue.
2. If you can’t get in touch with your broker, make sure you have used all the contact information provided before switching.
3. If you still cannot reach your broker, contact another department in the agency or a different broker directly to see if they can have a conversation with your current broker about their behavior.
4. If they ghost you (stop responding to you), reach out to the insurance company.
5. Contact the insurance company directly and see if they will talk to the broker on your behalf.
6. If you just want to switch health insurance brokers, request the change.

While rare, there are some instances when you may need to take legal action against a broker, such as discovering your broker lied in your application about your pre-existing conditions.

In this case, you must gather information and contact an attorney.