Health Insurance Accessibility: Evaluating Distribution Model And Their Impact

Abstract

Health insurance accessibility remains a crucial yet challenging aspect of achieving universal health coverage, particularly in underserved populations. With varying distribution models—such as direct-to-consumer, agent-based, broker-led, and digital platforms—the pathways to obtaining health insurance are diverse but unevenly effective. This review evaluates these distribution models, focusing on their impact on accessibility, health equity, and enrollment outcomes. A systematic review was conducted using databases such as PubMed, JSTOR, and Web of Science, selecting peer-reviewed articles, reports, and policy briefs published within the last 15 years. Studies were included based on relevance to distribution models and barriers affecting health insurance accessibility. Data were extracted on model type, target population, barriers, and outcome metrics related to accessibility and equity. The findings indicate that digital platforms improve accessibility in high-income and urban areas but face limitations in low-income and rural regions due to digital literacy and infrastructure barriers. Agent-based models are efficient in building trust and targeting the low-income population; however, they are expensive and difficult to scale. Broker-led models are more personalized but are more expensive than other insurance options. Altogether, every model has advantages and disadvantages when it comes to accessibility and equity. This review therefore calls for a combination of online and face-to-face approaches especially in areas of low access. It is recommended that the policymakers and insurance providers should subsidize the agent-based models and should launch digital literacy programs. Coping with these factors can contribute to explaining existing disparities in access to health insurance and bring the access to the state closer to equalization.