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Is it Worth Getting Private Health Insurance?

Is it Worth Getting Private Health Insurance? | Very Good Coverage

Although the costs of getting private insurance can be overwhelming, it’s still worth getting one, especially if you’re ineligible for public health insurance.

As private health insurance premiums become more expensive, Americans taking out private health insurance to cover them for hospital treatment has been on a worrying decline. Even if you have no choice but only to purchase your own health insurance through a private health insurance provider, you’re probably still wondering; is private health insurance really worth the struggle?

Whether or not private health insurance is worth it depends on your situation and what you sign up for. Basic private health insurance covers tests and surgery both at the hospital and day-care surgery. You may be entitled to additional medical services if you pay higher premiums.

In this brief article, we’ll highlight some of the reasons why we believe that private health insurance is worth it if it’s your last and only option of getting health insurance.

What is Private Health Insurance?

Private health insurance simply refers to any health insurance coverage that is offered by a private entity and not from the state or federal government. With private health insurance, you have many options in terms of how to enroll including:

  • Employer-sponsored health insurance such as group health plan
  • Licensed agents such as eHealth
  • State or federal marketplace plans
  • Choosing short-term coverage between plans
  • Enrolling in catastrophic coverage if you’re eligible

How to Buy Private Health Insurance

Of course, it’s impossible to buy private health insurance directly from the federal or state government. If you are not eligible for Medicare or Medicaid and your employer doesn’t offer group health plans, your only option may be to buy private health insurance through the health insurance marketplace or from private insurance companies.

What Does Private Health Insurance Cover?

Like most insurance plans, the type of coverage that you get from private health insurance pretty much depends on the type of policy that you purchase. As noted earlier, basic private health insurance will cover in-patient treatments (tests and surgeries) as well as day-care surgery.

Some other private health insurance policies may extend to out-patient treatments including visits to specialists and consultants.

What Does Private Health Insurance Exclude?

Some of the things that private health insurance won’t cover include:

  • Organ transplants
  • Cosmetic surgery to improve your appearance
  • Injuries relating to dangerous sports

It’s also important to note that Obamacare prohibits any discrimination based on gender or pre-existing conditions.

Who Might Need Private Health Insurance?

Whether or not you feel that private health insurance is worth it, certain situations make it more likely that you might need private health insurance. Let’s highlight some of them.

A Young Adult Aged 26 or Older

Under Obamacare, young people can be covered by their parents’ health insurance policy until they attain the age of 26. After that, they’re required by the law to seek out their own insurance policy.


If you were employed but lost your job, you may be eligible to maintain that coverage for a few more months through a program known as COBRA (Consolidated Budget Reconciliation Act). It allows you to maintain the health insurance coverage for up to 36 months under certain circumstances, though the cost of enrolling for COBRA is very high.

The idea here is that your former employer only pays for a portion of your healthcare premiums while you have to pay the rest of the cost. That being said, you may have to resort to private health insurance if you are unemployed.


An individual who runs his/her own business or works as a freelancer may be eligible for public health insurance if his/her spouse has public health insurance. But if that’s not the case, then he/she may have private health insurance as the only option.

A Part-time Employee

Generally, part-time jobs do not offer health benefits. You are working for less than 40 hours a week so many employers are not obligated to provide you with health insurance. As such, your only option may be to get your own private health insurance.

If You Retire

You’ll most likely not be eligible for employer-sponsored health insurance when you retire. Again, you might be under the age of 65, which would mean that you are still not eligible for Medicare. Under such a scenario, your only choice may be to purchase individual private health insurance until you turn 65 when you’ll be eligible for Medicare.

If You Own a Business and has Employees

As a business owner, you probably have employees who might require you to offer them health insurance. By offering health insurance to your employees, you remain a competitive employer and can help you attract qualified employees. As such, you can purchase a business health insurance plan or group plan to offer insurance coverage to your employees.

If You are Dropped by Your Current Insurance

Even though Obamacare prohibits health insurance companies from dropping a policyholder or canceling coverage, these things can sometimes happen and you find yourself with private health insurance as your only option.

Who Doesn’t Need Private Health Insurance?

You may not need private health insurance if:

  • You rely on employer-sponsored health insurance
  • You rely on public health insurance offered by the state and federal governments
  • You can afford to pay for individual treatments
  • You rely on government programs such as Medicare and Medicaid

How Much Does Private Health Insurance Cost?

It’s important to note that private health insurance is generally more expensive than employer-sponsored health insurance or public health insurance offered by the government. The average cost of private health insurance is around $440 per month ($5,280 per year) for an individual and $1,168 per month ($14,016 per year) for a family.

You can, however, get multiple quotes and compare plans, what type of coverage is offered, and whether you can afford it.

Benefits of Private Health Insurance

Here are a few benefits of Private Health Insurance.

More Control over Your Healthcare

Private health insurance gives you the flexibility of choosing your own doctor and hospital from those that participate within your insurer’s system without having to worry about increased fees.

This can be very assuring if you have a serious medical condition that requires the attention of the best doctors and the best medical facilities. That being said, private health insurance is certainly worth it if you want a particular doctor, surgeon, or specialist to be on your medical care.

Private Hospital Room

One of the main benefits of private health insurance is that it gives you the option of getting treatment in a private hospital room. Unlike public health insurance where you’ll find yourself in a hospital room with four to six other patients, private health insurance gives you the option of requesting a private hospital room, though this may be subject to availability.

No Waiting for Treatment

Perhaps the biggest benefit of having private health insurance is that you won’t have to queue or stay on the waiting list to have your medical condition fixed. Unlike public health insurance that can have you on the waiting list for months on end particularly if your condition isn’t life-threatening, private health insurance gives you the flexibility of choosing another hospital or doctor if your preferred one has a long waiting list.

Enjoy Greater Peace of Mind

If there’s one thing that you can’t quantify and put a price on, it’s the peace of mind that having private health insurance gives you. With private health insurance, you get peace of mind knowing that no matter what happens now or in the future, you and your loved ones are covered.

Potential Disadvantages of Private Health Insurance

Here are a few drawbacks of private health insurance.

High Costs

Private health insurance can be quite expensive, especially when compared to public health insurance. The premiums and out-of-pocket expenses are a bit costlier than public health insurance.

Complex Products

Many private health insurers offer a wide range of products that it can be too confusing to choose health coverage that suits your needs and budget. Without health insurance expertise, most of these products can be overwhelming and challenging to understand.

This is one of the main reasons why we often encourage our readers to seek the services of a professional health insurance agent to walk you through these complex issues. You certainly do not want to enroll in health coverage that you do not fully understand.

So is Private Health Insurance Really Worth it?

Whether or not private health insurance is worth it is a personal choice. While it is a bit more expensive than public health insurance, it has some benefits that can sway your decision. No matter what you choose, make sure that it suits your needs and budget.

Again, taking private health insurance can seem too overwhelming. In case you need some guidance, you can call us on (877) 204-0125 for expert advice.


Greg McKnight

Read more about Greg McKnight

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