What Is Private Health Insurance?

Private Health Insurance is the term used to describe any type of health coverage that isn’t provided or offered by the state or federally. There are multiple avenues to secure private insurance options; whether that be through the public marketplace, or an independent broker, or even an employer.

Similarly to employer coverage, one might also enroll in a private plan through group insurance, or less traditional health insurance methods such as cost-sharing. Lastly, private insurance companies are not legally required to be ACA compliant.

Private health insurance usually offers 1 or 2 (or even more depending on your insurance provider) insurance plans; furthermore private health insurance is eligible to any members as long as they can pay a Premium. (Premium is the amount of money that a person pays per month to their insurance provider).

What is public health insurance?

Public health insurance is a program funded by the government covering partial treatment costs and even the entirety. This plan does not cost a lot because the government covers a part of it or fully pays for it; in some countries, however, public health insurance plans have criteria to be eligible to apply for (disabled or elderly or others).

What is covered by private health insurance?

Most private health insurers provide a variety of offers to their potential clients; furthermore, these insurance plans cover plenty of expenses such as;

Ambulance cover

patients who require ambulance trips to reach the hospital are often covered by private health insurance, unlike public health insurance, which does not cover it.

Hospital cover

patients have the right to choose which doctor to treat them and even choose whether they will be taken care of in a private or public hospital. This also covers your hospital stay bills and others.

General treatment cover

individuals who are enrolled in private health insurance have their expenses covered when it comes to treatment costs like dental treatment or hearing aids and others.

What may not be covered?

Some expenses and services may not be covered depending on your tier and type of private health insurance. For example, services that are already covered by Public health insurance are exempted from Private health insurance costs.

Other cases apply, including and not limited to; Non-health related operations Meaning cosmetic surgeries are not covered. Long stay patients Meaning patients that have been in the hospital for more than 35 days in a row are expected to pay out-of-pocket for the prolonged stay. However, the patient starts paying only after 35 days

Patients who choose private single rooms may be surprised to realise that their insurance doesn’t cover its cost , Private insurance usually covers the full cost of a shared room, however when it comes to a single room costs may vary depending on your provider.

Who provides private health insurance?

Private health insurance is often provided by private health insurance companies that are specialized in this field, but an employer can provide private health insurance to their employees. However, Keep in mind that employers aren’t obliged to provide health insurance for their employees.

Difference Between Public And Private Insurances

Public Insurance is health care offered by the federal government such as Medicaid and Medicare. These insurance policies are put in place to insure those who cannot financially contribute to a health care system; such as children and the elderly. It also provides insurance to women who are pregnant, and individuals with low income who cannot afford healthcare.

A major difference between securing coverage through the public and private market, is that private market insurances do not offer financial assistance (discounts) based on income – as they do not take household income into consideration when calculating monthly costs. In this sense, private health insurance are usually more affordable than full price plans offered on the public market place.

What Are The Benefits Of Private Health Care?

Private insurances are open year round for enrollment, which means you can sign up for a private health care plan at any time of the year. Unlike the public marketplace; which is only open from November to December (during Open Enrollment) unless you experience a life qualifying event making you eligible for special enrollment.

If you miss open enrollment, and don’t want to risk waiting for the next November to roll around, private insurances also offer short term plans to fill the gap in case of emergency (but it is important to keep in mind that short term plans are not full coverage and not ideal to sustain for long periods of time.) 

How To Get Private Health Insurance

These days, buying private health insurance is simplified; checking services like the Health insurance marketplace offers a wide variety for individuals, families, and businesses with multiple plans tailored for their specific needs.

When choosing a plan, you are often expected to pay a Premium. Multiple private insurance plans come in many tiers; Higher tiers come with better benefits. 

With so many private health insurance options available on the market; it may be overwhelming to determine what coverage may be best for your specific situation. If you believe private care may be best for you and your family, don’t hesitate to consult a health care professional and #ask the Art of Insurance.