Leveraging AI to Simplify Health Insurance Shopping


  • AI is simplifying the complex task of shopping for health insurance.
  • Many Americans stick with suboptimal plans due to the difficulty of making informed choices.
  • AI tools gather individual data to provide personalized health plan recommendations.
  • Companies like Alight, The Big Plan, and Healthpilot are leading the AI revolution in insurance shopping.
  • Health insurance brokers see AI as a tool to enhance their services, not replace them.
  • Studies show AI tools can save consumers money and improve broker assistance.

Main AI News:

In the midst of the frenzied speculation about how artificial intelligence (AI) is poised to revolutionize healthcare, some companies are taking a different approach – using AI to improve the often daunting task of shopping for health insurance. The significance of this development cannot be overstated, as many Americans tend to stick with their health plans year after year, potentially missing out on better and more affordable options due to the complexity of the process. In this article, we will explore how AI-powered tools are transforming the health insurance shopping experience and why it matters.

The Challenge

Choosing the right health insurance plan has long been a perplexing challenge for consumers. Americans, whether purchasing private Medicare Advantage plans or shopping on the Affordable Care Act (ACA) marketplaces, are faced with a dizzying array of options, each with varying costs and access to healthcare providers. The sheer complexity of this task often leads individuals to opt for the status quo rather than exploring potentially more suitable plans.

The AI Solution

To address this issue, companies are leveraging AI to create tools that simplify the health insurance shopping experience. These AI-powered tools gather essential information about an individual’s insurance needs and preferences, utilizing this data to generate personalized recommendations for the best health plan options. Several companies have already embraced AI to facilitate this process:

  1. Alight, a cloud-based HR services provider, reports that 95% of the employers it serves use AI technology, including virtual assistants, to assist employees in selecting health benefits during open enrollment.
  2. The Big Plan, an AI-driven health insurance matchmaker launched for ACA open enrollment, offers customers the top three health plan options based on factors such as income, prescriptions, and preferred doctors.
  3. Healthpilot, a specialized AI startup focusing on Medicare coverage, aims to eliminate commission bias by helping patients choose health plans without undue influence.

Benefits for Brokers and Agents

Contrary to fears that AI might threaten jobs, health insurance brokers and agents recognize the potential benefits of AI in their industry. Advanced AI can automate routine tasks, freeing up time for brokers to provide more personalized services to their clients. Jessica Brooks-Woods, CEO of the National Association of Benefits and Insurance Professionals, acknowledges the role of AI in enhancing the client experience. The industry trade group is even planning to launch an “app store” in early 2024, making AI tools available to its members.

Human Touch in the Age of AI

While AI offers efficiency and data-driven recommendations, it doesn’t always understand the psychological nuances of what customers seek. Startups like The Big Plan still offer human customer service advice alongside their AI platform, recognizing the value of the human touch in providing guidance and empathy.

Proven Savings and Reliability

Studies have shown that AI-based decision tools in Medicare Advantage marketplaces can save consumers an average of $278 and reduce variability in the quality of brokers’ help. This demonstrates that AI can be a reliable and cost-effective resource for individuals seeking health insurance.


While technology-driven tools to aid health insurance decisions aren’t new, the current excitement surrounding AI can spark greater consumer interest in these tools. However, it’s important to note that professional input from brokers and agents remains valuable, especially for deciphering insurance terminology and navigating plan options. In the evolving landscape of health insurance shopping, AI is a powerful tool that complements, rather than replaces, the expertise and guidance of human professionals. Ultimately, the goal is to make shopping for health insurance less of a daunting task and more of an informed, personalized choice for every individual.