Private Medical Insurance (PMI), sometimes called private health insurance, is an insurance policy intended to pay for private healthcare. It is a quicker and more convenient way for people to receive medical care at private facilities instead of using the government’s public health services.
It is healthcare coverage offered by a private organization rather than the government. The most popular method of coverage for Americans is private health insurance. According to estimates from the U.S. Census Bureau, 66% of Americans have private health plans.
What is Private Medical Insurance?
The agreement between you and a private medical insurance provider stipulates that the insurer must cover all or part of your medical costs as long as you pay your premiums.
You can get private health insurance directly from a carrier via the Affordable Care Act (ACA) marketplace or your job. For medical issues that arise after the start of your coverage, it usually pays for the cost. Prices can change significantly since different policy types offer varying levels of coverage.
Certain policies allow you to receive treatments and tests more quickly or even therapies the NHS does not offer. Additionally, you can decide if your family, spouse, or health insurance plan should cover you.
Your insurance company will receive a monthly direct debit payment from you, and you can make claims as needed.
Types of Private Medical Insurance
You can purchase a variety of private health insurance policies:
- Employer-sponsored health insurance.
- ACA marketplace plans.
- Individual health insurance directly from an insurance company.
- Short-term health insurance.
- Catastrophic health insurance.
These are the types of private health insurance available.
What Does Private Medical Insurance Cover?
Private health insurance plans usually cover preventive, hospital, and medical treatment. Their coverage varies greatly; however, they can assist in covering a variety of medical services, including:
- Hospital services.
- Medical services.
- Mental health services.
- Prescription drugs.
- Specialist care.
- Rehabilitation and physical therapy.
Depending on the type of medical insurance, a private health plan may or may not cover care received outside of your provider network.
Benefits of Private Medical Insurance
The perks of this insurance include the following:
- Reduced waiting times.
- Specialists referrals.
- Choice of hospital and surgeon.
- Private rooms.
- Specialist treatments.
- Recovery and aftercare.
These are the perks of this insurance.
Cons of Private Medical Insurance
The cons of private medical insurance include:
- It can be costly, particularly as you age.
- Pre-existing medical issues are not covered
- Chronic illnesses are not covered
- It doesn’t cover injuries sustained from high-risk hobbies like extreme sports.
Mentioned above are some of the potential disadvantages of this insurance.
Top Companies That Offer Private Medical Insurance
Some of the top-rated companies that offer this insurance include:
- UnitedHealth Group.
These insurance providers are well-known for their wide product offerings and vast networks.
How to Obtain Private Medical Insurance
Here’s a comprehensive guide to successfully enroll:
- Consider your present state of health, any prescribed drugs, any ongoing medical conditions, and any upcoming surgeries. This will assist you in figuring out how much coverage you require.
- Determine your monthly budget for the cost of your health insurance premiums and the amount you can afford to pay for deductibles, copayments, and coinsurance.
- Research various health insurance companies such as Anthem, Cigna, Humana, etc., and the policies they provide first. This can be done online via their websites.
- Look at the features of each plan, such as the extent of coverage, the cost of the premiums, the deductibles, the out-of-pocket maximums, the provider network size, and any extra benefits.
- You must provide your contact details, identification, income, etc. Certain insurers may also ask a medical examination or requests for your medical history.
- Once you’ve decided on a plan, complete the application form and review it carefully to ensure accuracy.
Learn how to use your new health insurance plan after you’ve enrolled and understand where to look for in-network providers.
Frequently Asked Questions
Here are some frequently asked questions.
What is Considered as Non-private Medical Insurance?
Medicare, Medicaid, or CHIP programs are not private medical insurance.
Is the Cost of Private Medical Insurance High?
Yes. Generally, it is more expensive than insurance supported by the government.
What is the Cost of Private Medical Insurance?
The average annual cost of health insurance in the United States in 2023 was $23,968 for a family plan and $8,435 for a single policy. However, this price may differ significantly based on your insurance needs, the state where you reside, and the extent of coverage you need.
Getting your own health insurance policy is not as easy as signing up for an employer’s plan, but at least you have control over the plan that you get. With the many options available, you can probably find a plan that meets your needs and your budget. Further research can be done on Google if need be.