Private health insurance
Coverage for doctor visits, prescriptions, hospital stays and the unexpected. Many plans can be bought any time of year. Here are your options, and how I help you choose.
Types of plans
Every person's situation is different, so I work with several kinds of coverage. Many people combine a main plan with supplemental coverage.
Private health plans
Full coverage for doctor visits, prescriptions and hospital care, often with PPO networks. Plans ask health questions, which can mean lower prices for healthy people.
- Enroll any time of year
- Coverage can start quickly
- Plans for individuals and families
Major medical plans
Comprehensive plans that cover a full range of care, including pre-existing conditions, with no health questions to qualify.
- Approval doesn't depend on your health
- Preventive care and prescriptions included
- Sign up during set enrollment times each year
Short-term medical
Temporary coverage for gaps, like between jobs or while you wait for other coverage to begin.
- Usually a lower monthly cost
- Covers less than a full plan
- May not cover pre-existing conditions
Supplemental coverage
Pays you cash when something covered happens, to help with the costs your main plan doesn't.
- Accident and critical illness
- Hospital indemnity
- Dental and vision
Why people choose private plans
- You don't have to wait for a yearly enrollment window for many plans
- Healthy people can often find lower prices
- Plans can be built around the doctors and coverage you actually use
- You can add supplemental coverage for extra protection
What to know before you buy
Not every plan covers the same things. Some plans limit or exclude pre-existing conditions, cap certain benefits, or don't cover some services.
Before you sign up, I'll walk you through what's covered, what isn't and what you'd pay in common situations, so there are no surprises later.
Network types
The network is the group of doctors and hospitals a plan works with. It decides who you can see and how much it costs.
- PPO
- The most flexibility. You can see any doctor, and you'll pay less when you stay in the network. No referrals needed for specialists.
- EPO
- You use in-network doctors, but you usually don't need a referral to see a specialist.
- HMO
- You use doctors in the plan's network, and you usually pick a primary care doctor who refers you to specialists. Often lower cost.
Terms worth knowing
The words that decide what you'll actually pay.
- Premium
- What you pay every month to keep your coverage, whether or not you use it.
- Deductible
- What you pay for covered care each year before the plan starts sharing the cost.
- Copay
- A flat fee for a service, like $30 for a doctor visit.
- Coinsurance
- Your share of a bill as a percentage, like 20%, after you've met your deductible.
- Out-of-pocket maximum
- The most you'll pay for covered care in a year. After you reach it, the plan pays 100% of covered services for the rest of the year.
- Underwriting
- When an insurance company reviews your health answers to decide whether to approve you and what to charge.
- Pre-existing condition
- A health condition you had before your coverage started. Some plans cover these fully, and some limit or exclude them.