What is indemnity insurance?
Indemnity insurance is also known as fixed benefit insurance or fee for service insurance. An indemnity plan offers limited benefits. The plan pays you a preset — “fixed” — payment when you receive any of the qualified medical services specified in the plan. The benefit paid out stays the same no matter what the total bill for the qualified service was. That’s why fixed indemnity insurance can also be called fixed benefit insurance or fee for service insurance. It’s meant to supplement a more traditional health insurance plan.
What do Health ProtectorGuard fixed indemnity plans cover?
Health ProtectorGuard1 fixed indemnity plans help cover some of the most common medical costs you and your loved ones might face. These plans offer a preset benefit amount. Some benefits increase the longer you have a plan.
See how Health ProtectorGuard fixed indemnity plans can help cover costs
With your fixed indemnity plan benefits, you may be able to:
Apply benefit payments toward your other health plan's deductible
Get cash to help cover prescription drug copays
Help pay your share of lab or diagnostic costs, like for blood tests or X-rays
Have money for unforeseen expenses from a planned or an unplanned surgery
How do Health ProtectorGuard fixed indemnity plans work?
When you have a Health ProtectorGuard plan, these are the steps you'll need to take to use your benefits.
You or your provider submit a covered expense. The fixed benefit for that covered service is then paid, no matter what other insurance coverage you may have.
You don't have to meet a deductible before you receive benefits.
You choose the doctor or health facility you need.2
You can go to any doctor or health care facility you want. However, you may save money with discounted rates for services if you use providers in your plan's network (varies by state).
You can apply year-round, not just during an enrollment period or because of special circumstances.
Frequently asked questions about hospital and doctor fixed indemnity insurance
Explore FAQs about indemnity insurance to learn how to choose a plan for you.
Indemnity insurance can help you manage potential out-of-pocket costs from your main health insurance plan. This includes expenses like deductibles, copays and coinsurance — things you pay before your insurance plan pays benefits.
Health ProtectorGuard fixed indemnity insurance can help you pay for some of these out-of-pocket costs you’re responsible for under your main medical plan.
With traditional health insurance, your plan typically pays for all or a percentage of covered expenses after you meet a deductible, pay a copay or reach an out-of-pocket cost limit. You pay for qualified expenses first, then your insurance company usually covers their portion based on the terms of the policy.
Fixed indemnity insurance flips how you’re paid. You or your provider are paid a predetermined, fixed amount of benefit for covered health care expenses. After that, you’re responsible for the rest.
Fixed indemnity insurance is not major medical insurance. Fixed indemnity insurance provides limited benefits, paying a set amount for covered services up to a maximum for the year. It doesn’t cover all the essential health benefits outlined by the ACA and doesn’t qualify as the minimum essential coverage. Also, it will not cover expenses related to preexisting conditions for the first 12 months of coverage. In fact, it’s designed more as a supplement to a major medical plan.
It’s important to understand these differences:
- Indemnity insurance does not provide the coverage required 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 from preexisting medical conditions for the first 12 months of coverage
Nothing beyond your monthly premium, which is what you pay to have the plan. You don’t have deductibles or copays with fixed indemnity insurance. If you have services provided for a covered expense, the benefit is paid after the claim is submitted.
Yes. The fixed indemnity insurance plan pays you for the covered expense, even if your other health insurance plan also covers that service.
No, where you go for care is up to you. Since you are paid a fixed amount for covered services up to an annual maximum amount, the plan doesn’t restrict you to a specific network of doctors or providers.
In some cases, however, you could save money by choosing to stay within a network of providers offering lower rates through your Health ProtectorGuard fixed indemnity plan.
Keep in mind that your main health insurance may require you to stay within a certain network of providers.
Yes, in some plans. Many Health ProtectorGuard plans come with fixed benefits paid for a certain number of prescription fills per year. Plans in most states come with a prescription discount card to help with the ongoing costs of medicine.
Yes, many Health ProtectorGuard plans pay a fixed benefit for specified preventive or wellness services.3
In some states, Health ProtectorGuard plans come with an included telehealth membership so you can access a doctor by phone or app without leaving your home.
Learn more about Health ProtectorGuard fixed indemnity insurance
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