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Important Insurance Questions to Ask During OEP

Important Insurance Questions to Ask During OEP text overlaying image of an agent questioning For insurance agents, the open enrollment period is all about customer service. This is the time for you to use the skills you’ve learned throughout the years to help families and individuals look at their needs and finances to ultimately decide on an insurance package. While much of the focus should be on providing your clients with helpful information and suggestions. To get a solid understanding of their needs and wants, you’ll need to ask the right questions. You almost want to interview each client and try to get a glimpse into their minds and life. Asking questions during the sales process will not only make it easier for you to suggest them with the best coverage. But it will also ensure them that you truly care about their wellbeing.


To help you get off on the right foot during every client interaction that you have, we’ve outlined some of the most helpful questions that agents should be sure to mention during OEP and why each one is so important. Even if you are already a highly successful agent, these questions can serve as a checklist to see if there’s any crucial information, you’re forgetting about addressing. 

1.Do you have any new health conditions or Medical concerns? 

When new health concerns or conditions arise, a client’s current policy may not suffice anymore. Asking about medical conditions or other serious concerns will allow you to accurately assess the client’s risks and pair them with coverage that addresses their needs. Without knowing about these types of changes, you won’t be able to suggest necessary plan features. Such as specialty doctors, treatments and more. 

2.Have you experienced any major life changes? 

While we generally pay the most attention to a person’s healthcare needs during the OEP. There are various non-medical related life changes that can affect an individual’s insurance status. Check in with your clients about things such as recent marriage, divorce, adoption or birth of child, a change in employment status or the death of a family member. By having a firm understanding of any life changes that have occurred over the past year, you’ll be able to suggest them with coverage options that fit their situation. This can also prevent unfortunate events like having too much insurance or uninsured periods.

3.Are your current prescription medications covered by your plan? 

If you yourself take any prescription medications, then you probably know that without the proper insurance, the costs can be astronomical. For this reason, you’ll be doing your clients a big favor by checking in with them to see if their current plan covers their medications. If they are unsure, when reviewing last year’s coverage or looking at new options, take the time to make them aware of what drugs are covered. As well as any other associated costs and alternative or generic medications that could save them some money. By going through this practice, you will be able to ensure that your client leaves with prescription drug coverage. So, they won’t get hit with unexpected costs later down the line. 

4.What is your monthly budget for premiums and out-of-pocket costs?

Since the insurance industry is so competitive, for many clients, the price point that you can offer will be the main determinant of which coverage they select. Before getting into the weeds of specific plans and their details. You should ask them about any financial concerns or restrictions that they may have. Try asking them what is a number that they’d be able to afford when it comes to monthly premiums, deductibles and copayments. This will help you to be able to offer them a plan that fits both their financial and health needs. 

5.Do you have any upcoming health expenses or planned procedures?

Just like having any new medical conditions, knowing that a client has an upcoming medical procedure or other health related expense can be a large factor in determining what coverage is right for them. Talk to your clients in detail about this and pay particular attention to them mentioning any surgeries, treatments or pregnancies. By being in the know about procedures and major expenses, there will be no chance of clients coming back to you saying that they are underinsured. 

6.Are you completely satisfied with your current provider network?

During your conversations it is crucial to get a gauge for your clients’ happiness when it comes to their preferred provider. Specifically, ask them about their network of doctors and specialists and if they are satisfied. Conversely, ask them if they are ever using doctors that are out of network. If they are, it’s your job to make sure that they know that this will lead to higher costs. And to suggest to them a plan that better fits their preferences. 

7.Are you interested in supplemental benefits? 

Most insurance packages offer some types of supplementary benefit options. Examples of these benefits include vision, dental, mental health and other wellness programs. Bringing up this question is a great way to see if your clients have additional needs that aren’t met by their basic coverage. Additionally, this conversation provides a great upselling opportunity for you which can result in more income. 

8.Do you regularly travel outside of the United States? 

While this question isn’t as common, asking your clients about their travel habits, especially outside of the country is crucial in determining what coverage is best for them. Many common plans have very limited coverage when it comes to being outside of the United States. With that said, if you’re serving a client who travels internationally on a regular basis. You’ll have to offer them some type of travel medical coverage. 

9.Do you qualify for financial aid or subsidies?

Some clients who have limited income or other situations may qualify for subsidized coverage or financial assistance. Ask them specifically about things like Medicaid and other tax credits that could help them save money. To get ahead of things, when preparing for OEP it may be worth it to ask clients with subsidies or financial aid to come prepared with that information on hand for your first meeting. You yourself wouldn’t want to miss out on potential savings if you were eligible, and neither do your clients!

10.Have you ever used telemedicine service? 

In recent years telemedicine services have become very popular. As it allows patients to access medical care and advice from the comfort of their homes. Many of your clients may have telemedicine services included on their current coverage plan, but simply don’t know, so having this dialogue will be helpful and educational. By offering clients the option to use telemedicine service for things like routine doctor’s visits, and other non-emergency meetings, they will be satisfied as it will save them time and stress. 

11.Are you aware of preventative services offered by your plan? 

Preventative services are oftentimes offered by insurance plans at no additional costs. These services are meant to help plan ahead, so that patients are less likely to have medical issues later down the line. Examples of preventive services include things like shots, screenings and other tests. Taking advantage of these services can help lower costs of premiums over periods of time, as they will lower the number of doctor and hospital visits a client receives. These services can also lead to early detection of disease or injury which in most cases will make it easier to treat. 

12.Have you reviewed your current policy’s terms and conditions? 

While it is your responsibility to make sure that your client has a thorough understanding of the fine print when it comes to their policy. You should also encourage them to read over the terms and conditions by themselves. These terms include important information about policy exclusions. As well as limitations and other monetary details that can cost time and money if ignored. If you want to go the extra mile, you can offer to read through these details with your client, putting any complex information into layman’s terms. This practice will reduce the number of confusions and potential disputes in the future. 

13.Do you have any questions about your new/existing coverage? 

Whether your clients are opting into a new insurance plan or if they are renewing the same one. It’s vitally important that you ask them if they have any pressing questions. These plans have a lot of details. So, it can be easy to miss something even if you are an insurance expert. Additionally, even if keeping the same plan, details tend to change from year to year. So, it’s definitely worth it to make sure there are no loose ends so to speak. By making sure that all of their questions are answered, they will have a firm understanding of what their insurance plan includes. While feeling supported and heard by you. 


While OEP serves as a time for you to help clients with your insurance expertise. It is equally important to perfect your listening skills. Some clients will tell you everything you need to know about them. But for others, you’ll need to ask the right questions in order to learn their preferences and circumstances. Once you have a detailed understanding of their life and what is important to them, you can then offer the coverage of their dreams. By remaining informed, and up-to-date about your clients, you will be able to provide customized recommendations that ultimately give them peace of mind. OEP is about enrolling clients, but it is also about building and upholding relationships. What better way to do that than by offering valuable guidance in the form of a comprehensive healthcare plan. 


If you are an insurance agent or other professional who is looking for ways to grow your business and make more sales, you’ve come to the right place! For over 15 years Benepath has specialized in insurance lead generation, connecting interested consumers with agents like you. We offer both data leads and inbound phone calls in various verticals. Including individual health, group health, Medicare, life and commercial insurance. If you’d like to learn more about purchasing our leads give us a call at 888-684-3121. Or fill out a form today!

About The Author: Cassandra Love

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