5 Factors To Consider When Choosing Health Insurance

With healthcare costs rising, finding affordable health insurance that meets your needs is more important than ever. In 2024, premiums for the Affordable Care Act (ACA) health insurance marketplace plans increased by 6%, forcing many to seek new options that fit their budget without giving up essential coverage.

Private health insurance plans are affordable and offer coverage designed for specific situations and professions. But how do you know what to look for in a private plan? Whether you’re choosing a plan for the first time or searching for a more affordable option, this guide to buying private health insurance will help you understand what to look for and how to make the best choice for your needs.

1. Understand Your Coverage Needs

Choosing the right private health insurance program starts with knowing your specific circumstances. To get the most out of your plan, consider how your job, lifestyle, and health impact your health benefit needs. These questions can help guide your decision:

• How often do I expect to use healthcare services? Consider your healthcare needs. If you don’t require frequent care, a plan with lower premiums and a higher deductible could save you money. Regular visits may be better suited to a plan with higher premiums and lower costs per visit, balancing your overall expenses.

• What type of work do I do? Your job affects your healthcare needs—both what the plan covers and how it’s structured. For instance, if you work as a truck driver or travel nurse, you need a plan with national coverage to avoid costly out-of-network fees while traveling for work.

• Am I self-employed or running a small business? Being self-employed or running a small business means you need flexible plan options that cover both you and your employees. Choose an affordable private health insurance plan that helps you balance cost and coverage to meet everyone’s healthcare needs.

• Do I have ongoing health conditions? If you have chronic conditions or require regular prescriptions, select a plan that provides comprehensive coverage for these services. This can help you avoid high out-of-pocket costs while maintaining the care you need.

2. Know the Types of Health Insurance Plans

When selecting private health insurance, there are several types of plans to choose from with different levels of coverage and flexibility. Understanding these options helps you choose one that matches your healthcare needs and budget.

• Health Maintenance Organization (HMO):
  Requires you to select a primary care physician (PCP) and get referrals for specialists.
  Considerations: Lower premiums but restricts you to in-network providers. Good for those who prefer coordinated care but limit provider choice.

• Exclusive Provider Organization (EPO):
  Similar to an HMO but doesn’t require referrals for specialists.
  Considerations: No referrals are needed, but coverage is limited to in-network providers. Ideal for those who want more direct access but still need in-network care.

• Preferred Provider Organization (PPO):
  Allows you to see any doctor without a referral.
  Considerations: Higher premiums, but you can visit both in-network and out-of-network providers. More flexible, but expect to pay more for the freedom.

• High Deductible Health Plan (HDHP):
  Offers lower monthly premiums with a higher deductible.
  Considerations: Best for those who don’t need frequent medical care. Often paired with a Health Savings Account (HSA) for tax-free savings on medical expenses.

3. Costs and Premiums

One of the biggest factors to consider when choosing a health insurance plan is the cost. Health insurance plans come with various expenses, including monthly premiums, deductibles, copayments, and coinsurance. Here’s what to look at when comparing health insurance near you:

• Premium: This is the monthly amount you pay for your insurance plan. Average annual premiums vary by state, health insurance company, and plan type. Ask about your private health insurance plan premiums and select an option you can easily cover each month. 

• Deductible: A deductible is the out-of-pocket amount before your insurance begins covering medical expenses. The average deductible cost in 2023 was $1,735 for single payer coverage. A higher deductible often means lower monthly premiums, which is ideal if you don’t expect to need frequent medical care. 

• Copayments and Coinsurance: These are cost-sharing methods that determine how much you pay after you’ve met your deductible. For example, you may have a $20 copay for a doctor’s visit or pay 20% coinsurance for a hospital stay. Select a plan with affordable copayments so you can access care when you need it without paying too much out-of-pocket.

4. Open Enrollment and Special Enrollment Periods

If you’re wondering, “Can I buy private health insurance at any time?” it depends on your situation. Generally, you can only enroll or switch plans during the open enrollment period unless you’ve had a qualifying life event, like marriage, the birth of a child, or losing job-based coverage.

Private health insurance plans can offer more flexibility. If you’ve missed open enrollment, you may still qualify due to a life event, or you can look into short-term health insurance to bridge the gap until the next enrollment period.

Check your state’s rules, as enrollment periods and plans offered can differ by location.

5. Additional Benefits and Programs

Many private health insurance plans offer more than medical care, with wellness benefits like mental health services, gym memberships, and prescription drug coverage. Some plans also include well-being programs that promote healthy lifestyles, such as discounts for fitness centers or nutrition support.

For those who qualify, premium tax credits lower your monthly health insurance costs by reducing what you pay upfront. Other tax incentives, such as medical expense deductions and premium deductions, can further lower the cost of private health insurance, depending on your situation. 

Look for a private health insurance plan that includes these extra benefits to support your well-being while keeping your costs manageable.

Find the Right Health Insurance Plan for Your Needs

Selecting the right health insurance plan means considering your healthcare needs, budget, and provider options. At United National Healthcare, our private plans provide flexibility, comprehensive coverage, and access to a wide network of trusted providers, helping you get the care you need when you need it most.

With customized options for individuals, families, and small businesses, you can find the United National Healthcare private insurance plan that meets your needs and provides the right coverage for you and your family. 

Ready to find affordable coverage tailored to your situation? Contact us for a free quote and let us help you explore options that fit your needs and budget.