Fixed indemnity insurance frequently asked questions (FAQs)
Get answers about Health ProtectorGuard hospital and doctor insurance
Fixed indemnity plans1
A fixed indemnity plan sends you a preset — “fixed” — payment when you receive any of the qualified medical services specified in the plan. The money 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.
No, it isn't. 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. In fact, it’s designed more as a supplement to a major medical plan.
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Once a qualified service is performed, the health facility, doctor, or you submit a claim for that service. The preset benefit is then paid. If the preset amount doesn't cover the total expense, you pay what's left of the bill. If there's any benefit money left after the service is fully paid, you receive what remains to use as you see fit.
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 a covered expense, the benefit is paid after the claim is submitted.
Right after a qualified expense. Once you have received services for expenses that are covered by your hospital and doctor fixed indemnity plan, a claim can be submitted by the health facility, doctor or you. In some states, there may be a waiting period for wellness expenses. See brochure for more details.
To help you manage potential out-of-pocket costs from your major medical plan.
Whatever your main health insurance plan is, it comes with out-of-pocket expenses. Deductibles, copays, co-insurance — these are all things you pay before your insurance plan pays benefits.
Health ProtectorGuard fixed indemnity insurance can help meet some of these out-of-pocket costs you are responsible for under your main medical plan.
Check out options to get cash for qualifying medical expenses.
Yes. It pays you for the covered expense regardless of overlap from what other health insurance you have might cover.
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. All plans 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.2
In a number of states, Health ProtectorGuard plans come with an included telehealth membership so you can access a doctor by phone or app without leaving your home.
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