What Not to Tell Your Health Insurance Agent

What Not to Tell Your Health Insurance Agent. 12 Things I Keep to Myself.

When I shop for health insurance, I think hard about what to say. I also think about what to keep to myself.

If you have ever wondered what not to tell your health insurance agent, you are not alone. It is one of the first things people ask before they shop for a plan. I asked it too.

Here is what I have learned. A good agent can save me time and money. But an agent is also a salesperson. Most agents get paid by insurance companies when I sign up. So I choose my words with care.

This guide covers 12 things I do not say to my agent. It also covers six things I always share. I wrote it in plain words, so you can read it right before your next call.

One quick note. I am not a lawyer or an agent. Rules can change by state. Please check the facts for your state.

The short answer

I never lie to my agent. I also do not hand over more than I need to. Here is my short list:

• I do not guess about my income.
• I do not fib about tobacco.
• I do not say, “Just pick the cheapest plan.”
• I do not let anyone change my plan without asking me first.
• I do not give my Social Security number to a stranger who called me.

The rest of this guide explains why. It also gives you the exact words I use instead.

The first rule: I can stay quiet, but I never lie

There is a big difference between keeping quiet and lying.

Keeping quiet means I don’t offer facts nobody asked for. That is fine. Lying means I give a false answer to a real question. That is never fine.

Lying on a health insurance form can be fraud. The law is kind about honest mistakes. An insurance company cannot cancel my plan just because I made one. But it can cancel my plan if I put false facts on my form on purpose.

So my rule is simple. If a question is on the form, I answer it. I answer all of it, and I tell the truth. If a question is not on the form, I stop and ask, “Why do you need to know that?”

How my agent gets paid

Most agents do not charge me a fee. The insurance company pays them when I sign up. This pay is called a commission. That is not a bad thing. It is just good to know.

It means two things for me:

1. A Marketplace plan costs me the same whether I use an agent or not.
2. Some agents may push the plans that pay them the most.

That is why I watch what I say. My words can lead me to a plan that fits my life. Or they can lead me to a plan that fits the agent’s paycheck.

Agent, broker, or free helper: who am I talking to?

The person on the phone could be one of three kinds of helpers. I always ask which one.

• An agent often sells plans for one company or just a few.
• A broker can sell plans from many companies.
• A navigator is a trained helper who does not sell plans. Navigators do not earn a commission, and their help is free.

All three can be great. But the answer tells me how wide my choices are. It also tells me who is paying for the help.

What can change my price, and what can’t

This part surprised me the most. For a Marketplace plan, my health does not change my price. Marketplace plans are also called ACA plans or Obamacare plans.

By law, only five things can change what I pay each month:

1. My age
2. Where I live
3. Whether I use tobacco
4. Whether the plan covers just me or my family too
5. The plan level I pick, such as Bronze, Silver, or Gold

And here are three things that cannot change my price:

• My health today
• My medical history
• Whether I am a man or a woman

So what does this mean for me? Say an agent is selling me a Marketplace plan. Then the agent starts to dig into my health history. That is when I slow down. The agent does not need those facts to give me a price.

These plans must also cover health problems I already have. That coverage starts on day one.

But all of this is only true for Marketplace plans. Other kinds of plans follow different rules. I explain those further down.

12 things I don’t tell my health insurance agent

Here is my full list. Each one comes with what I say instead.

1. “I don’t use tobacco” (when I do)

Tobacco is one of the few things that can raise my price. Insurers can charge tobacco users up to 50% more. So it is tempting to fib. I don’t.

If the insurer finds out, it can bill me for the extra cost all the way back to the start of the plan year. That could be one big, ugly bill. A few states, like California and New York, do not allow this extra charge at all.

What I say instead: The truth. Then I ask, “How will my price change after I quit?”

2. A guess about my income

“I make about forty thousand, I think.” That kind of guess can hurt me.

My income decides how much help I get with my monthly bill. That help is a tax credit. If I guess too low, I get too much help. Then I may have to pay it back at tax time. If I guess too high, I pay more each month than I need to.

What I say instead: “Here are my pay stubs and my last tax return. Let’s use real numbers.”

3. “Just pick the cheapest one”

The lowest monthly price is not always the cheapest plan. A low price often comes with a high deductible. A deductible is what I pay before the plan starts to pay. One trip to the emergency room can wipe out all my savings.

What I say instead: “Show me what I would pay in a normal year and in a bad year.”

4. “I never go to the doctor”

This sounds harmless. But it tells the agent I will take thin coverage. And nobody plans for a broken arm or a burst appendix.

What I say instead: “I am healthy right now. I still want a plan that protects me if that changes.”

5. The most I can pay

If I say, “I can go up to $600 a month,” guess what happens? I tend to see plans that cost close to $600. I may also hear about add-ons that fill the gap, like dental, vision, or accident plans.

What I say instead: “Please show me three plans at three prices. I will tell you which one fits.”

6. My whole health story, when the plan doesn’t need it

For a Marketplace plan, my health history cannot change my price. So I do not walk through every checkup and test I have ever had. It just puts my private facts in one more file.

There are two big exceptions. I do share my doctors and my medicines, so the agent can check that the plan covers them. And if a form asks a health question, I answer truthfully.

What I say instead: “Does this plan use my health history to set my price or to approve me? If not, let’s skip it.”

7. A guess on a health question

Some plans do ask about my health. I cover them below. With those plans, a wrong answer can cost me my coverage later. So I never say, “I think that test was fine.”

What I say instead: “I need to check my records. I will call you back.”

8. “You can fill in the rest for me”

The form has my name on it. If something on it is wrong, I pay for it. So I do not let anyone fill in blanks for me while I look away.

What I say instead: “Please send me the form. I want to read every line before you turn it in.”

9. “Change my plan any time you think it’s best”

This one scares me. Some bad agents switch people to new plans without asking. They do it to earn a new commission. Many people only find out when they go to the doctor.

The problem is growing fast. A 2026 government report reviewed complaints found to be true. From 2023 to 2025, the number grew to more than four times as many.

Agents on the federal Marketplace must get my consent before they sign me up or change my plan. I make sure mine knows I expect that.

What I say instead: “Do not change anything unless I say yes in writing first.”

10. My Social Security number, to someone who called me first

A real agent does need some private facts to sign me up. But I only share them with an agent I picked and checked.

If a stranger calls, texts, or runs an ad that promises free money or gift cards, I walk away. Those ads are a common trick.

What I say instead: “Give me your name and license number. I will look you up and call you back.”

11. “Yes” to a question I didn’t understand

Many agents record their calls. A quick “yes” can count as my consent. So I do not say yes just to be polite or to speed things up.

What I say instead: “Please say that again in plain words.”

12. “I need a plan today. I’ll take anything”

Rushing is how I end up in the wrong plan. A pushy agent loves a buyer in a hurry.

Most of the time, I have more days than I think. On HealthCare.gov, I can sign up for a 2027 plan from November 1, 2026, to January 15, 2027. If I sign up by December 15, my plan starts on January 1. Some states use other dates, so I check mine.

Open enrollment for Medicare health and drug plans starts on October 15, 2026, and runs through December 7, 2026. All plan changes made during this eight-week window will officially take effect on January 1, 2027.

What I say instead: “I will decide by Friday. Please email me the plan details.”

Say this, not that: my quick cheat sheet

I keep this short list next to my phone.

6 things I always tell my health insurance agent

Keeping quiet is only half the job. Some facts help my agent find a plan that works. If I hide them, I only hurt myself.

1. My doctors and hospitals. Plans only cover some doctors. I give my agent a list, so we can check each name.
2. My medicines. Each plan has its own list of drugs it will pay for. I share the exact name and dose of each one.
3. Care I know is coming. A baby, a surgery, or weekly therapy changes which plan level is best. On a Marketplace plan, this cannot raise my price.
4. My real income and who is in my home. These two facts set how much help I get with my bill.
5. The truth about tobacco. Yes, it may cost more. Lying can cost much more later.
6. Big life changes. A move, a wedding, a new baby, or losing my old health plan can let me change plans in the middle of the year.

Think of it this way. I share facts that help the agent match me to a plan. I skip facts that only help the agent sell me more.

When health questions do matter

Not every plan is a Marketplace plan. Some agents also sell other kinds of coverage, such as:

• Short-term health plans
• Fixed-payment plans that pay a set amount per day or per visit
• Health sharing plans, which are not really insurance

These plans often cost less. But they can play by very different rules. Many of them can:

• Ask about my health
• Turn me down
• Refuse to pay for a health problem I already had

With these plans, the health questions matter a lot. Say I give a wrong answer, even by mistake. Later, I get sick and send in a big claim. The company may dig through my medical records. If it finds a mismatch, it may cancel my plan back to the first day. Then the bills are all mine.

So here is what I do with any plan that asks about my health:

1. I ask to see the questions in writing.
2. I read each one slowly.
3. I answer all of them, and I tell the full truth.
4. I keep a copy of my answers.

The first thing I ask is always the same. “Is this an ACA Marketplace plan, or is it something else?”

How I check an agent before I share anything

Before I share one private fact, I take ten minutes to check the agent. Here is how:

1. I ask for the agent’s full name and license number.
2. I look up the license on my state insurance department’s website. The search is free.
3. I ask which companies the agent can sell for. More companies means more choices for me.
4. I search the agent’s name online with the word “complaints.”
5. I ask for an email with the agent’s name and phone number, so I have it in writing.

If any step fails, I stop there. There are plenty of good agents. I do not need to settle for one I cannot check.

7 red flags that tell me to walk away

Most agents are honest and helpful. A few are not. Here is how I spot the bad ones:

1. They called or texted me first, and I never asked for help.
2. They promise free cash, gift cards, or “$0 insurance for everyone.”
3. They rush me to say yes today.
4. They will not give me a license number.
5. They will not send plan details in writing.
6. They will not say what kind of plan it is.
7. They tell me to change my income or leave something off the form.

That last one is the biggest. If an agent tells me to lie, I hang up. My name is on the form. I am the one who gets the bill if it goes wrong.

7 questions I ask before I sign up

I like to turn the tables. I ask the agent questions too.

1. Are you licensed in my state? What is your license number?
2. Which insurance companies do you work with?
3. Is this an ACA Marketplace plan?
4. Are my doctors in this plan?
5. Are my medicines covered?
6. What is the most I could pay in a very bad year?
7. Can you send me all of this in writing?

A good agent is happy to answer every one. If an agent gets annoyed, that tells me a lot.

Questions people ask me most

Is it against the law to lie to my health insurance agent?

It can be. Lying on an insurance form to get a better deal can be fraud. I could lose my plan. I could also owe money back. Staying quiet about things nobody asked is fine. Giving a false answer is not.

Can my agent see my medical records?

No. An agent cannot pull my medical records on their own. Some plans outside the Marketplace may ask me to sign a form that lets the insurance company look at my records. I read that form with care before I sign it.

Can I be turned down because of a health problem?

Not for a Marketplace plan. Those plans must take me and must cover problems I already have. Other plans, like short-term plans, can turn me down or refuse to pay for those problems.

Does it cost more to use an agent?

Not for a Marketplace plan. The price is the same either way. The insurance company pays the agent, not me.

What if I already told my agent something wrong?

I fix it fast. I call my agent or the Marketplace and update my form. An honest mistake that I fix is a small problem. A wrong answer that I leave alone can grow into a big one.

What if my agent changed my plan without asking me?

I act right away. If I have a HealthCare.gov plan, I call the Marketplace Call Center at 1-800-318-2596. I also tell my state insurance department. Both can help restore my old plan.

Do I have to use an agent at all?

No. I can sign up on my own at HealthCare.gov or on my state’s website. I can also get free help from trained helpers who do not earn a commission. The Find Local Help tool lists them by zip code.

The bottom line

Knowing what not to tell your health insurance agent is not about hiding things. It is about being careful with my words.

I tell the truth every single time. I answer every question on the form. But I do not guess, rush, or give away my right to choose.

Before my next call, I will do three things:

1. Gather my pay stubs, my list of doctors, and my list of medicines.
2. Write down my seven questions.
3. Check my agent’s license on my state’s insurance website.

A good agent will respect all of this. And if one does not, I will find another agent who does.

Why choose Steve Turner Insurance Specialist?

Because I’m an “Insurance Specialist.” An “insurance specialist” is a broad term that includes insurance agents and insurance brokers, but the key difference is who the agent represents versus who the broker represents.

An “insurance agent” works directly for an insurance company and sells its specific policies to clients.

An “insurance broker” acts as an independent intermediary, comparing policies from multiple companies to find the best fit for their client’s needs, essentially representing the client rather than the insurance company.

I am both a licensed Insurance Agent and a licensed Insurance Broker.

My number one goal in life is to help people and ensure, without a shadow of a doubt, that you and your family are secure and protected. I will always be by your side, helping you mitigate risk by providing the industry’s best and most affordable insurance solutions.

I will find insurance plans for the entire family to help cover whatever life throws at you. I can help you save on severe medical emergencies, find a health insurance plan with low- or no-cost doctor visits and affordable prescription medications, and protect your family in the event of an unexpected accident or illness.

Best of all, it doesn’t cost you anything extra to use an experienced Insurance Agent and Broker like me to help you find the Insurance Plans that fit your individual, family, or business needs.

The companies that sell the insurance plans “you choose“ pay me – you don’t pay me. Calling any big insurance company directly won’t get you a lower price, as they will forward your call to the next available insurance agent on their list. You won’t have had any opportunity to learn about the insurance agent you’re speaking with in advance, understand their qualifications or experience level, or make an informed choice about who you want to work with.

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