In the realm of healthcare, artificial intelligence (AI) is finding application in a more straightforward yet crucial task – easing the process of shopping for health insurance.
The significance: Despite the transformative potential of AI in healthcare, some companies are utilizing this technology to simplify the often daunting task of selecting health insurance. Many Americans tend to stick with their health plans year after year, unaware of potentially better and more affordable options due to the complexity of predicting their future healthcare needs or assessing available deals.
Companies are now introducing AI-powered tools to enhance the shopping experience, a development even embraced by brokers and agents who view the technology as a valuable aid rather than a threat to their existence.
Context: These AI tools prove especially beneficial for the millions purchasing private Medicare Advantage plans or navigating Affordable Care Act (ACA) marketplaces independently.
While those covered through workplace plans may have a limited number of options, individuals exploring ACA marketplaces during the current enrollment season are confronted with an average of 100 plan choices, each differing in cost and access to healthcare providers. The average enrollee in Medicare Advantage plans has seen the number of available plans more than double to 43, according to health policy research nonprofit KFF.
How it operates: AI tools typically gather fundamental information about an individual’s insurance needs and use this data to generate predictions for the best health plan options.
Alight, a cloud-based HR services provider, reported that 95% of the employers it serves utilized AI technology, including a virtual assistant, to aid employees in choosing health benefits during fall open enrollment.
The Big Plan, an AI-driven health insurance matchmaker launched last year for ACA open enrollment, presents the top three health plan options based on factors like income, prescriptions, and preferred doctors.
Healthpilot, an AI startup focusing on Medicare coverage, positions itself as a solution to eliminate the “commission bias” that brokers may have, guiding patients to specific health plans.
Industry perspective: Health insurance brokers working with companies and individuals believe that advanced AI could enhance their business rather than replace their roles.
Jessica Brooks-Woods, CEO of the National Association of Benefits and Insurance Professionals, anticipates that AI will allow them to automate routine tasks and allocate more time for personalized interactions with clients.
The trade group is preparing to introduce an “app store” in early 2024, providing members with access to such tools.
Human touch: Some startups, like The Big Plan, supplement their AI platforms with human customer service advice, acknowledging that AI lacks a psychological understanding of customer needs.
Carey Gruenbaum, CEO of The Big Plan, emphasized the importance of human input alongside AI, citing that AI may not always grasp customers’ psychological nuances.
Studies and reality check: While AI-driven tools for choosing health insurance plans are not entirely novel, the current AI hype may increase consumer interest in these tools.
Louise Norris, a broker and policy analyst at healthinsurance.org, suggested seeking input from a professional despite the availability of decision-support tools, emphasizing the value of brokers in helping consumers navigate complex insurance terminology and plan options.
