Private Insurance: What You Gain and Why It Matters

What Are The Benefits Of Private Insurance?

Health insurance shouldn’t chain you to a job or force you to give up the doctors you trust. We sit down with Katherine Clark of Fredrick Insurance Brokers to unpack how private coverage can create real freedom: plans that follow you through career changes, broader networks that help you keep your pediatrician or specialist, and options to tune deductibles and out-of-pocket limits to your budget. If you’ve ever felt stuck choosing between confusing tiers at work or narrow marketplace networks, this conversation offers a fresh, practical path.

We walk through smart ways families can save by moving spouses and kids off costly group add-ons, why many private plans offer PPO access without the top-tier employer price tag, and how underwriting can reward healthy lifestyles with lower premiums. Katherine shares how she customizes plans by asking the right questions—care usage, prescriptions, travel needs, and risk tolerance—then bundles benefits to reduce surprises and protect against big bills. The real win is clarity: understanding the trade-offs between premiums, deductibles, and maximum out-of-pocket so you pick coverage that matches how you actually use healthcare.

Service is the quiet advantage. Instead of waiting on hold with a giant call center or relying on HR to translate fine print, you get a dedicated advocate who helps with network checks, billing snags, and plan adjustments as life changes. With years of experience that predate the Affordable Care Act, Katherine brings hard-earned insights into what works today and how to avoid common pitfalls. If you want coverage that fits your life—portability, provider choice, and sensible costs—this episode lays out the steps to get there.

If this helped you see new options, follow the show, share it with someone comparing plans, and leave a quick review so more people can find it. Got questions about private insurance or PPO access? Send them our way and we may feature them next time.

To learn more about Fredrick Insurance Brokers visit:
https://www.FredrickInsuranceBrokers.com
Fredrick Insurance Brokers
Dallas-Fort Worth, Texas
972-375-0507

Transcript

Welcome And Purpose

SPEAKER_00 0:03

Welcome to the Frederick Insurance Brokers Podcast, where health insurance finally makes sense. Your hosts, Katherine Clark and John Frederick, are independent health insurance specialists and co-owners of Frederick Insurance Brokers. Family-owned, faith-grounded, and serving individuals, families, the self-employed, and small businesses across the country with options instead of headaches. Around here, they're known as health insurance brokers with a heart, guiding you toward quality care that's simple, affordable, and aligned with real life. So if you've ever thought health insurance is confusing, expensive, and definitely not fun, you're in the right place. Let's dive in and take the fear out of coverage one conversation at a time.

SPEAKER_01 0:59

Private insurance offers more than just coverage. It can mean flexibility, choice, and peace of mind. Welcome everyone. I'm Julie Schwenzer, co-host and producer in the studio with Katherine Clark of Frederick Insurance Brokers. Catherine, thank you again for joining us. Welcome. Hi Julie, nice to see you today. It's very nice to see you. So let's dive into this one. What are the benefits of private insurance?

Job Independence And Pre‑Existing Concerns

SPEAKER_02 1:25

Well, there's a couple of benefits. Um is not being tied to your job. People don't think about that, but think about your friends and family, and they're like, oh, you know, they're looking for a new job, they get laid off, they they want to quit, but they can't quit because they have their health insurance. And they have to have group insurance because maybe they have a pre-existing condition. So if you have private insurance, as long as you make your payments every month, you keep that insurance. So I like to advise people to when they go and apply for a job, number one, they don't have to worry if they provide insurance, but maybe even negotiate a higher rate of pay and pay for your own insurance. Um, it would cost the company less if they're it even if they gave you like a stipend. So if you have private or independent insurance, people refer to it different ways, you're not tied to your job. If you have private insurance and you come down with something that would be considered a pre-existing condition, you aren't going to lose your insurance. But if you have a job and you come down with something and now you do have a pre-existing condition, that's going to limit what kind of private or independent insurance you can get. So, isn't it better in that case? It's better to start with private insurance, right? Additionally, private insurance you have to qualify for, and this doesn't mean that you know there are people that have high blood pressure and some small things. We're talking about major things would keep you from qualifying for it, but because people are healthy, the premiums are lower, and that's huge.

SPEAKER_01 3:14

And also, can you explain how provider choice it's broader with private plans?

SPEAKER_02 3:20

Well, typically when you work for a company, they're gonna have one plan that they offer you, and maybe it's you know a major company like a blue cross, and they might have three plans, but it's still all with that carrier or that specific network. When you have private insurance, there's a lot of selection. So you could choose from many different networks. So that means your work insurance, maybe your doctor doesn't accept that. Private insurance, you're more likely to be able to keep your doctor, you know. There's one thing that you should know too about the why you want to have private insurance, and that is if even if your job pays for your insurance, which would make that a better deal for you, or pay for half of it, you absolutely will save money if you put your spouse and your kiddos on outside insurance, not on your group insurance at work.

SPEAKER_01 4:21

Okay, and then what about you meant you touched on this already, but customization, how can that play in private insurance coverage? And also you you mentioned something key that I hear a lot from friends, family, co-workers, is being able to keep your doctor. That's huge. It is huge, right?

SPEAKER_02 4:40

Um, you know, that the people that have a you know, like a pediatrician, they they definitely want to keep that. So, you know, if that pediatrician accepts, you know, Aetna and United Healthcare and Cygna, but they don't accept Blue Cross, and Blue Cross is what's being offered at work, you know, that's the issue that you run into. As far as customization goes, um, that's really can be pretty complicated to teach to somebody. But what I do when a client comes to me is that I ask the questions and kind of figure out what their needs are so that I can figure out a way to maybe bundle something that's going to bring their pricing down, um, you know, what their habits are. If they if they don't go to the doctors very much, I would like maybe suggest a different plan that costs less. So you have a little bit more, well, it's better service, right? Because we're focused just on you and what you or and or your family's needs are, as opposed to where you're maybe at work, you have like a choice between three, you know. So it um it's not something that I could explain to you what I do, just you would just want to know that I'm gonna ask the right question and try to get you in the best plan. And I typically can give you two or three choices and give you the good, bad, and the ugly because there's no perfect plan, you know, help you figure out you know what makes the most sense.

Costs, Deductibles, And More Options

SPEAKER_01 6:17

And something that hits home for everybody, the wallet. Um, can you talk more about and help us understand more like that there is flexibility with out-of-pocket costs when it comes to private insurance?

PPO Access And Who Qualifies

SPEAKER_02 6:31

Um, there is in the sense that you can choose plans that have a max out-of-pocket. I mean, you can in the in the group world as well as the private world, I mean, as well as the ACA world. ACA stands for Affordable Care Act, otherwise known as Obamacare or the Marketplace, but um you don't have as many choices. So, with again, with the private or the independent, you there typically are more choices that are gonna make more sense for your family. Um and and of course, the max out of pocket and the deductible is what's gonna make the difference also in the premium. So you have to balance need with budget, right? Um, but you just have more, you you just have more options in the private world, if you will.

SPEAKER_01 7:23

So I know this is kind of a general question, but would you say then to healthier clients or clients who maintain a healthy lifestyle that private insurance may be the way to go?

SPEAKER_02 7:36

Yes, because you do have they do have medical questions and you do need to qualify for that. Um but the uh the other advantage to it is that most of the private plans are PPOs, which means you get to choose your doctor. Typically, when you go within a marketplace plan, ACA plan, there are no PPO plans, and there's a reason for that. And at work, of course, you can get a PPO plan, but it's going to be the most expensive one they offer you at work.

SPEAKER_01 8:10

And from your clients, what kind of feedback do you hear often when they do switch to private?

SPEAKER_02 8:17

Um, I would say the service, because I'm accessible and I can guide them. Whereas if they're have a work plan, they're having to deal with HR, and that's not always helpful to them. If they have an ACA or a marketplace plan, then they have to deal with the big conglomerates where you know the prompting and on the phone for an hour sort of thing. So I would say with the service, you're dealing with a a smaller entity because you have your own customer service line, but if push comes to shove, you know, then then they have me. So that's that's probably what makes it a little bit better experience because like none of us like health insurance are paying for it. So it's kind of nice to have somebody to talk it through with.

Experience, Takeaways, And Closing CTA

SPEAKER_01 9:13

Oh, absolutely. And how many years have you been in the uh private insurance business? Since way before we had Affordable Care Act.

SPEAKER_02 9:21

So I want to say 2007, maybe 2006, I can't remember exactly.

SPEAKER_01 9:27

So wow. Yeah, so upon the 20-year-old.

SPEAKER_02 9:30

Yeah, it's been a long, it's been a long time, so I've seen lots of changes, and unfortunately, it's not better today than it was back then. Um, but you know, that's probably the reason that I kind of know some of the ways around things that maybe others might not know.

SPEAKER_01 9:53

Absolutely, your experience and your commitment to your clients that shows through, you know, these discussions that we're having, and we appreciate you because insurance can be so overwhelming to so many of us. So we appreciate you breaking down everything for us.

SPEAKER_02 10:09

Well, you're welcome. Yeah, I enjoy helping uh people navigate it. It's uh I like to see the light bulb go off on them too. They're like, oh, okay, I'll do that.

SPEAKER_01 10:20

Yeah, you know, I I imagine too, some people, I mean, after dealing with whatever insurance obstacles they have throughout their life or health challenges, it's like it's just so much easier to if you can. I know life is hard and and we all get thrown curveballs sometimes, but um just to be healthy is so helpful.

SPEAKER_02 10:39

Oh yeah, that can that can make a difference. Knock on wood. I I am still um in good health and plan to be for a long time because that if you don't have your health, you don't have anything, right?

SPEAKER_01 10:52

Oh, absolutely. What you know it's amazing when when you're very sick, all you can think about is feeling better, and then when you're better, you know, some things pop up in I think all of our minds that might not, you know, be as important, you know.

SPEAKER_02 11:06

So yeah, but it's it can be all consuming, that's for sure.

SPEAKER_01 11:10

When you're when you're not when you're sickly, yes. Absolutely. Well, Catherine, thank you so much for sharing the benefits of private insurance with us. We do appreciate it. You're welcome, thank you.

SPEAKER_00 11:24

You've been listening to the Frederick Insurance Brokers podcast with Katherine Clark and John Frederick. Health insurance brokers with a heart. If you're ready for health coverage that actually fits you, not the other way around, schedule a no-obligation consultation today. Visit Frederick Insurance Brokers.com or call 972-375-0507. Because peace of mind shouldn't be a mystery, and your health insurance shouldn't need a translator.