Hospital and Doctor Insurance
Fixed indemnity plans
Hospital and doctor fixed indemnity insurance is also often called fixed-benefit insurance or fee for service insurance. That’s because this type of insurance pays you a set—that is, fixed—amount of money for specific services covered by the plan.
Unexpected medical bills can disrupt even the healthiest home budgets. Health ProtectorGuard1, underwritten by Golden Rule Insurance Company, is a fixed-benefit insurance plan that can help you deal with the unexpected by paying you or your provider a preset benefit amount for some of the most common medical costs you and your loved ones might face.
With a Health ProtectorGuard indemnity plan:
- You are paid regardless of other insurance coverage.
- You don’t have to meet a deductible before you receive benefits.
- Your fixed benefits are paid straight to your provider or to you after a covered expense is submitted.
- You choose the doctor or health facility you need.2
- You can apply year round, not just during an enrollment period or because of special circumstances.
What is indemnity insurance?
A fixed indemnity plan like Health ProtectorGuard is much different than a major medical insurance plan.
A regular major medical health insurance plan pays for all or a percentage of covered expenses after you meet a deductible, pay a copay or reach a certain amount of out-of-pocket costs. Put simply, for qualified expenses, in most cases, you pay first, and then your insurance company covers the rest.
A fixed indemnity plan offers limited benefits and is meant to supplement a more traditional health insurance plan. Indemnity insurance essentially flips how you are paid when compared to major medical insurance. You or your provider are paid a predetermined fixed benefit for certain health care expenses you have incurred, and then you are on your own for the rest.
Fixed indemnity insurance is not major medical insurance and does not provide the mandated coverage necessary to avoid a penalty under the Affordable Care Act (ACA). It does not provide coverage for all the essential health benefits outlined in the ACA. It will most likely not provide coverage for expenses resulting from preexisting medical conditions.
Why indemnity insurance?
For these reasons, and others, a Health ProtectorGuard fixed-benefit indemnity plan is uniquely suited to help fill in health coverage gaps.
Apply benefit payments toward your other health plan's deductible
Get cash to help meet prescription drug copays
Help pay your share of lab or diagnostic costs, like for blood tests or X-rays
Have money for those unforeseen expenses surrounding a planned or an unplanned surgery
Health ProtectorGuard can be a financial leg up to help you stay on top of your bills.
How do I use my indemnity insurance?
It’s simple. You or your provider just submit a covered expense. The fixed benefit for that service is then paid, regardless of other insurance coverage.
1 THIS PRODUCT PROVIDES LIMITED BENEFITS. This is a supplement to health insurance and is not a substitute for the minimum essential coverage required by the Affordable Care Act (ACA). Lack of major medical coverage (or other minimum essential coverage) may result in an additional payment with your taxes.
2 If you have a major medical plan, remember that you may need to stay with certain networks and providers to get the most coverage out of that plan. Take that into consideration when choosing where you get your care.
No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
References to UnitedHealthcare pertain to each individual company or other UnitedHealthcare affiliated companies.
Each company is a separate entity and is not responsible for another's financial or contractual obligations.
Administrative services are provided by United HealthCare Services, Inc. or their affiliates.
Products and services offered are underwritten by Golden Rule Insurance Company, Health Plan of Nevada, Inc., Oxford Health Insurance, Inc., UnitedHealthcare Life Insurance Company, UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of New York, Inc.
This policy is subject to various exclusions and limitations. For costs and complete details of the coverage, call (or write) your insurance agent or the company (whichever is applicable).