Recently, we at the NDNRC were asked about the involvement agents and brokers have had with enrolling people with disabilities in marketplace plans and Medicaid. As we have not had any direct experience with agents and brokers, we turned to our network of Community Outreach Collaboratives (COCs) and other liaisons to learn their experience. This blog post is meant to summarize what we heard and look at some resources that navigators and assisters should know about when dealing with agents and brokers.
In a nutshell, the report we got back was mixed. There were some reports that agents and brokers did not have a sufficient knowledge of Medicaid, especially as it related to eligibility questions concerning income and household. There were also reports that individuals were signed up for plans that they did not choose or they were simply not enrolled at all even after being told that they were. As a result, many did not understand the coverage they received or had to abandon using the agent and instead sought out a navigator. We also learned of agents and brokers who simply dropped the ball and did not follow up with consumers despite repeated attempts to complete their application.
However, we did receive positive news about agents and brokers as well. For instance, it was reported to us that in other instances agents and brokers were very knowledgeable about Medicaid options and were better positioned to help consumers who had more complex health needs as they considered their options for coverage. We heard that this was especially true when the consumer was looking at plans that were higher than the silver coverage level.
All in all, navigators and assisters need to be aware that agents and brokers are another possible resource which consumers can utilize when considering their options in the marketplace. Navigators and assisters may want to consider the utility of agents and brokers and when a referral could be warranted. However, there are guidelines on what a navigator can say to a consumer regarding agents and brokers. The Centers for Medicare & Medicaid Services (CMS) released a tip sheet for dealing with agents & brokers earlier this year. To download a copy of this tip sheet, click here. The tip sheet is also available on our Resources & Links page under “Enrollment Resources – Overview”. Additionally, earlier this month, the CMS assisters webinar addressed agents and brokers in the marketplace. To download the slides from this presentation, click here.
Finally, if you have any comments/experiences (either positive or negative) that you would like to share with us concerning agents and brokers in the marketplace, be sure to let us know. You can provide information to us through our “Contact Us” page by clicking here.