What You Need to Know About Private Insurance img

Everything You Need to Know About Private Health Insurance in 2022

If you are like many people in need of health insurance, you may be scrambling to find a solid ACA health plan before open enrollment ends. However, did you know that Obamacare is not your only option for getting coverage? You are also eligible to get private personal or small business health insurance year-round. 

Private health insurance is any health insurance coverage offered by a private health insurance company instead of a state or federal government. Insurance brokers and companies both fall into this category. Private health insurance gives you the flexibility you need to choose your health plan for yourself or your employees.

What Is Private Health Insurance?

Private health insurance is health insurance plans marketed by the private health insurance industry instead of government-run insurance programs. Private health insurance includes employer-sponsored plans. Americans also purchase private coverage outside of the workplace in the individual/family health insurance market, both on and off-exchange.

There are various types of private health insurance that are much less regulated than regular major medical coverage. Plans may include 

  • Short-term health plans
  • Fixed indemnity plans
  • Critical illness plans
  • Accident supplements
  • Dental and vision insurance

These types of coverage are all sold by private health insurance companies. Depending on your health insurance needs, various types of private health insurance can serve as supplemental coverage or act as primary coverage.

What Is the Difference Between Private and Public Health Insurance?

There are several differences between private health insurance and public health insurance.

Public Health Insurance

Public health insurance plans are plans provided by the government for individuals or businesses. Primary public health programs in the US are Medicare, Medicaid, and CHIP.


Medicare is a federal social insurance program for seniors (generally aged 65 and over) and certain disabled individuals. With the aging population, the costs of Medicare are projected to rise, so The Affordable Care Act has taken some steps to reduce the burden on 


Medicaid, which covers millions of very low-income children and their families, is funded jointly by the federal government and states but is administered at the state level. The Affordable Care Act dramatically expanded Medicaid.

Children’s Health Insurance Program (CHIP)

CHIP is a federal-state partnership that serves certain children and families who do not qualify for medical assistance but cannot afford private coverage. This program aims to supplement the coverage gaps between Medicaid and private insurance.

Private Health Insurance

Private health insurance refers to plans provided by private companies and are often provided by an employer or other organization with which the policyholder is affiliated. You can purchase it on a group basis or by individual consumers. Currently, most Americans receive their health coverage through private health insurance plans.

Group Health Insurance

Group health insurance is typically more generous than public healthcare insurance programs like Medicare. Since 2015, Obamacare has mandated that all employers with over 50 full-time employees provide affordable health coverage to employees to avoid a tax penalty. However, workers who receive employer-sponsored insurance tend to be paid less in wages due to the insurance premiums paid by the employer.

Individual health insurance

Individual health insurance plans are purchased for yourself or your family through no association with an employer or other organization. The costs of these plans may vary greatly, depending on what kind of plan you choose and what benefits you receive, but overall, individual health insurance plans tend to cost less than group insurance plans.

7 Benefits of Private Health Insurance

1. Shorter Wait Times

One potential benefit of private health insurance is that a shorter waiting period may apply for treatment. This may be particularly helpful for elective surgery, often involving long waiting times.

2. Private Hospital Rooms

Another potential benefit of private health insurance is the option of being treated in a private room. In a public hospital, you are often placed in a room with four to six other people with various conditions. Private health members can typically request a private room, which is usually subject to availability.

3. Money Back on Non-Medicare Health Services

Many sign up for private health insurance to receive a rebate on health services not covered by Medicare. For example, extras cover often covers you for dental, optical, chiropractic, and physiotherapy services. Without private health insurance, getting a filling or buying new glasses may be quite expensive.

4. Dental Insurance

Private health insurance may cover all or part of the cost of dental treatment. It can include things like checkups, all the way through to major dental work like root canals or wisdom tooth extraction. The exact amount your policy will cover you will depend on your insurer, so it could be worth checking in with them or reading your Product Disclosure Statement (PDS) if you’re unsure.

5. Select Your Health Care Provider

Many private health insurance policies allow members to select their preferred doctor or surgeon to carry out an operation. In a public hospital, your doctor will be the one on duty at the time of your operation. As with the availability of a private room, your preferred doctor or surgeon is still a matter of availability in the private system.

Contact Insurance Enterprise for Premier Health Insurance

If you have questions about the group or individual health insurance and need health insurance quotes, contact Insurance Enterprise at 786-254-0371. Speak to a licensed agent and find out more about how you can get an affordable health insurance plan.