Private health insurance is a broad term that covers any plan you purchase outside of government programs (like ACA/Obamacare or Medicaid) or employer-provided group insurance. These plans are typically designed to give you more freedom, flexibility, and customization but they also come with trade-offs.

Private plans can be a great fit for people who are:

- Making too much to qualify for ACA subsidies

- Frustrated with network restrictions

- Self-employed

- Between jobs

- Or simply looking for something more affordable or tailored to their needs

Types of Private Plans

Indemnity Plans (Fixed Benefit)

These plans pay set dollar amounts for specific services, no matter what the provider charges.

Pros:

- Cash payouts go directly to you

- Can use any doctor or hospital

- Combine with other coverage to reduce out-of-pocket costs

Cons:

- Payouts may not cover full costs

- Often excludes pre-existing conditions (12 months)

- Doesn’t work like traditional insurance

Short-Term Medical (STM)

Designed for temporary gaps in coverage, short-term plans last anywhere from 1 month to 3 months with the option of extending 1 month (depending on your state).

Pros:

- Affordable premiums

- Fast approval, often same day

- Flexible durations

Cons:

- Often excludes pre-existing conditions (12 months)

- Limited coverage compared to ACA

- Not renewable in most states

Private PPO Plans

These are privately marketed major medical-style plans (sometimes via associations or special networks).

Pros:

- Nationwide PPO networks

- Lower monthly premiums than ACA

- Custom options for families, self-employed, etc.

Cons:

- May not follow ACA rules

- Could be underwritten (you answer medical questions)

- Must read the fine print carefully

Health Sharing Ministries / Alternatives

These are not insurance, but they pool money among members to share costs.

Pros:

- Lower monthly cost

- May cover big medical events

Cons:

- Not legally bound to pay your bills

- Religious or lifestyle restrictions

- Can deny claims retroactively

No matter which private plan you choose, it’s smart to fill the gaps, because none of these plans will cover everything. That’s where supplemental coverage comes in.

You can add:

• Accident protection (pays if you break a bone or go to the ER)

• Sickness hospitalization (helps cover deductibles and inpatient stays)

• Critical illness (pays cash if you're diagnosed with things like cancer or heart attack)

• Dental & vision (can be added a la carte)

These stackable layers help you:

• Reduce your total out-of-pocket costs

• Stay protected if the worst happens

• Put cash in your pocket, not just toward bills

If you're healthy, self-employed, or just tired of sky-high ACA premiums, private coverage might be a smarter fit.

You won’t find these plans on Healthcare.gov or through your employer. That’s why working with a licensed agent (👋 hi, I’m Sam) matters. I’ll walk you through every option, compare pricing, and make sure you’re actually protected, not just technically insured.