Medical Concierge and Insurance Broker: What’s the difference?

If you find yourself hospitalized with the prospect of needing some serious care, it can help to have someone in your corner. Someone that knows all the insurance lingo can be a blessing when it comes to understanding and selecting care options, and the payment of care runs the gamut from super simple to downright confusing.

Luckily, those of you who are not experienced in navigating health sector processes and bureaucracies have a few options for getting help.

Your own insurer can be a port of call for obtaining advice on how to get treated. As the party that will likely be paying for your care (or at least most of it), they should always be one of the first people contacted when there may be a claim made on your insurance policy.

Alternatively, you might also want to consider enlisting the help of your insurance broker (if you purchased a policy through them), or through a medical concierge.

The benefits of having an insurance broker have been discussed on this site previously (see What Is an Insurance Broker?), but in relation to their role as a sales agent of insurance. A medical concierge, however, might be a completely unknown concept to many readers.

In this article, we’ll discuss the differences between what a broker and what a medical concierge can do for you when you find yourself in need of medical care.

Medical Concierge Companies

Medical concierge companies are not new ventures; many have been around for a few years now. Their role in the future of healthcare has been a topic of interest for many commentators on the industry (for a discussion of other recent trends, see Key Trends in International Private Medical Insurance). What they are and how they work may differ slightly from country to country, but the general concept remains the same: providing a subscription-fee-based health service at a competitive price.

What does that mean for consumers? It means that, instead of paying high fees for every single visit you make to the doctor, you might save money paying a monthly fee of $40 per month with unlimited access to your concierge company’s doctors. If you’re the sort of person who visits a doctor once a year, then the $150 fee may not break the bank. But if you visit multiple times a year, a monthly subscription may be a lot cheaper (learn more about All The Ways You Pay: Premiums, Deductibles, Co-pays, and Coinsurance).

Services Offered

What you generally find with concierge companies is that they will include a number of medical services to your subscription, including but not limited to:

• Liaising with medical care providers
• Personal chaperone to hospital appointments
• Wellness plans and assessments
• Arranging medical travel affairs
• Organizing emergency medical evacuations when necessary
• Sourcing medical care providers
• Reviewing your medical insurance claims
• Providing advice on disease and illness management

If you find yourself hospitalized, a medical concierge may be able to work with you and the hospital you’re in to ensure that the best care options are taken and that any and all payment and billing arrangements are made. You can think of them as a personal health assistant, both when you’re healthy and when you’re in need of care.

Insurance Brokers

Insurance brokers are first and foremost insurance product salespeople. Your first engagement with a broker will generally be when you’re looking for insurance—either for your first health policy or when you’re up for renewal and looking for a better deal than what you currently have. They act as an intermediary between yourself and insurance companies, providing you with great deals on policies from a wide range of insurers (see these 10 Tips for Choosing the Right Health Insurance Policy).

But did you know that they can help you during care and claim times too? Most insurance brokerages will continue to provide you with insurance and care support even after you have bought a policy from them.

Services Offered

The services a broker can offer are similar to those of a concierge, and include but are not limited to:

• Liaising with insurers and care providers
• Sourcing medical care providers
• Providing medical insurance claim reviews
• Submitting and processing claims
• Insurance plan reviews and renewal assistance

What sets brokers apart from concierges when you’re receiving care is that these services are often provided at no extra cost. Brokers make their money from the sale of insurance policies and renewals, so the support they provide in between those sales is the extra mile they go in the hope that you will keep doing business with them.

Large brokers will also have strong relationships with the insurers you hold a policy with, making it a lot easier to process claims.

Choosing the Right Option for You

In many ways, brokers and concierge companies overlap in how they help you with your healthcare needs. However, there are also a great many advantages that they don’t share. Medical concierges can, for instance, have agreements with certain clinics and hospitals to ensure that their clients choose them over alternatives, while some brokers may prefer some insurance brands over others that may be better for you.

When trying to decide between either of these alternatives to getting direct assistance from an insurer or simply doing it yourself, go with your gut instinct and ask around. The key is finding medical care support that you feel comfortable trusting when you find yourself in need of specialist advice. In truth, you may want to consider using both if your personal situation calls for it. Weigh your healthcare needs as well as your budget to help decide.