How Health ProtectorGuard works | UnitedHealthcare

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How does Health ProtectorGuard work?

Health ProtectorGuard, underwritten by Golden Rule Insurance Company, is a fixed indemnity insurance product.¹ This type of insurance works differently than other health insurance plans. It pays a fixed benefit amount for eligible medical expenses.

You may be in the habit of paying a share of the total covered costs. And that’s after you meet a deductible that you are responsible for covering before your insurance company pays anything. With Health ProtectorGuard, you get the immediate gratification of seeing some of your health care costs cut down up front.

If you have hospital and doctor fixed indemnity insurance, you are paid a set benefit per hospital or doctor service as specified in the plan. No deductible or cost sharing first. You get a specific medical service, and you are then paid the eligible fixed benefit for that service.

UnitedHealthcare: Health ProtectorGuard

Video transcript

(An upbeat electronic conga beat begins. The UnitedHealthcare logo appears and turns into a ribbon, gliding across the screen and revealing the words “UnitedHealthcare, Golden Rule Insurance Co. and Health ProtectorGuard”. A bright synthesizer orchestral tune is added to the conga beat. Two hands join together in a handshake to create a heart graphic on the left side of the screen. On the right, the words “Extra help for the “what ifs”” fade in.)

The bright voice of a young woman begins: A little extra help for the “what ifs” we all worry about.

(The words on the right half of the screen change to “Health ProtectorGuard”.)

Voiceover: That’s the power of Health ProtectorGuard.

(A stethoscope appears on one half of the screen; on the other half, the words “Medical Treatment”)

Voiceover: “What ifs” can be costly. Seeking medical treatment isn’t always cheap,

(The stethoscope and words disappear, and a wallet with a coin appears.)

Voiceover: and it can be hard coming up with the cash to cover doctor visits,

(Wallet disappears, and a doctor’s office graphic appears, followed by prescription and hospital graphics as they’re mentioned.)

Voiceover: prescriptions or maybe even something bigger like a hospital stay.

(Graphics are replaced by the words “Health ProtectorGuard” and dollar bill and heart graphics.)

Voiceover: Health ProtectorGuard is insurance that pays a fixed benefit amount for eligible medical services like office visits,

(Graphics are replaced by the words “Office visits”, “Prescriptions”, “Hospital stays”, and “Wellness visits” as they’re mentioned.)

Voiceover: prescriptions, hospital stays, surgeries with some plans, and even wellness visits after a 30-day waiting period. Health ProtectorGuard is not an Affordable Care Act plan.

(Previous words are replaced with “is not an Affordable Care Act plan”, “it is not for pre-existing conditions”, “flexible supplemental coverage”, and “You choose the benefit level” as they’re mentioned.)

Voiceover: It does not provide coverage for pre-existing conditions. It’s a robust supplemental insurance plan to give you extra flexibility based on your health care needs. You choose the benefit level that makes the most sense for the health services you use most often. Here’s a quick example: Let’s say you’ve had a bad cough, trouble breathing and a fever for a couple of days.

(A graphic with a person appears with an X-Ray revealing their lungs.)

Voiceover: You see your doctor and get a chest X-ray.You’re diagnosed with a severe case of pneumonia and need to be admitted to the hospital for a few days.

(A blood pressure cuff graphic appears.)

Voiceover: Your Health ProtectorGuard is ready to help with covered expenses.

(Graphic slides off the screen, replaced by the words “your plan pays” and on the right of the screen as they’re mentioned these graphics appear: a doctor’s office graphic and “$100”, an X-Ray graphic and “$50”, a hospital graphic and “$2,000”, and finally a bed graphic and “$4,000”. Underneath “your plan pays” in fine print it says: “Example based on HPG Select 2 plan”.)

Voiceover: Your plan pays $100 for the doctor visit, $50 for the X-ray, $2,000 for hospital admission and $4,000 for 2 days of inpatient hospital care.

(Graphics are replaced with the words “After claims are filed” on the left side of the screen with a document graphic and “$6,150” on the right side of the screen with a dollar bill graphic. Underneath in fine print it says: “Example based on HPG Select 2 plan”.)

Voiceover: After the claims are filed, the plan pays a benefit of $6,150 – regardless of any other health insurance coverage you may already have.

(The $6,150” with the dollar bill graphic slides to the left, replacing the words “after claims are filed.” The words “Directly paid to your provider” appear on the right.)

Voiceover: The $6,150 benefit is paid directly to your providers to help reduce and cover some of your bills.

(The upbeat gleeful tune in the background continues. Various healthcare related graphics appear in different sized circles.)

Voiceover: With Health ProtectorGuard, there are no network restrictions. You can choose any doctor or hospital you want. But you will see lower costs for care with providers in the UnitedHealthcare Choice Plus network.

(The words “Health ProtectorGuard” appear on top of the words “Choose any doctor or hospital” and “UnitedHealthcare Choice Plus Network” which fade in and fade out as they’re mentioned.)

Voiceover: Coverage is available for individuals and families – and you can apply at any time.

(A close-up graphic of a person with a heart bandage on their arm, as well as two raised hands appear.)

Voiceover: No need to wait for an enrollment period.

(An animated clock graphic appears and ticks, to the left of the words “Apply anytime” and “No enrollment period”, which fade in and fade out. The clock disappears and is replaced by the words “No deductibles'' and “Benefits paid regardless of other coverage” which fade in and out as they’re mentioned.)

Voiceover:There are no deductibles to meet, and benefits are paid regardless of other medical insurance coverage you may have.

(An animated graphic of a person holding a phone with a doctor on the screen appears to the left of the words “Telehealth available 24/7”)

Voiceover: And with Health ProtectorGuard, telehealth services are available 24/7.

(Telehealth graphic is replaced by an animated prescription graphic to the left of the words “Discounts on prescriptions” and underneath that, the words “with your Optum Perks card” in fine print.)

Voiceover: You also receive discounts on prescriptions with the Optum Perks card.

(A calendar graphic appears with the words “Doctor visits”, “Hospital stay”, and “Prescriptions” and “Telehealth” animate in.)

Voiceover: Health ProtectorGuard – simple, straight-forward benefits for covered services.

(A final screen with the words “UnitedHealthcare” and “Golden Rule Insurance Co.” in the upper left corner. In the center of the screen there are the words: “Health ProtectorGuard” and then “Questions? Call your local health insurance broker” and finally “See the product brochure for more information on benefits, exclusions and limitations.” At the bottom of the screen in fine print: “Underwritten by Golden Rule Insurance Company, a UnitedHealthcare Company, Product design and availability varies by state. This product is medically underwritten. This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. Benefits provided in stated amount regardless of the actual expenses incurred. Benefits are not paid for expenses resulting from preexisting conditions. For costs and complete details of the coverage, call your insurance agent or the company.

45387-G-0321”)

Voiceover: A little extra insurance help so you can have a little less worry about the “what ifs” of life.

Want to see fixed indemnity insurance plan options?

Not all plans are available in all states. See what's available in your state.

View plans

Questions? Call 1-844-744-4346

One of the best features of fixed indemnity insurance is that it can help with many common medical expenses you or a loved one might incur. Whether it's a quick visit to the doctor or urgent care, an unexpected lab expense or a surprise trip to get an X-ray, plans are designed to help with the kinds of health care costs many people face each year.

How does that actually work in practice? A couple examples can illustrate the benefits of adding a fixed indemnity plan to your insurance coverage.

A visit to a doctor

You have a Health ProtectorGuard Choice Plus fixed indemnity plan, in addition to your health insurance plan.²One day, you decide to go to your doctor after trying to endure a sore throat and headache that just won’t go away.

Your Choice Plus benefit for a doctor office visit is $100 per visit. You would be paid $100 for one visit after submitting this expense.

After checking your throat and neck, your doctor indicates she wants to test for strep throat. She swabs your throat and sends the swab to a lab for testing. The result comes back positive. You have strep.

Your Choice Plus benefit for an outpatient lab test like one for strep throat is $200 per test. You would be paid $200 for one test in this case.

Your doctor prescribes a generic antibiotic, which you fill at your pharmacy on the way home.

Your Health ProtectorGuard Choice Plus benefit for a generic prescription is $20, which is what you would be paid in this case.

So, after submitting your expenses, the total benefits you would receive from your Health ProtectorGuard Choice Plus plan in this example is $320.

Important

The scenarios on this page are just examples of how a fixed indemnity insurance plan might work for you. Health ProtectorGuard insurance plans can complement other insurance you have, but they have their own explanations of what services are covered and what services aren't.

The following link takes you to the product brochure, which has more details about coverage to help you decide if a plan will work for you.

A Trip to the ER

You have a Health ProtectorGuard Premier Plus plan, in addition to your health insurance plan.² One evening, you suddenly feel sharp stomach pain that won’t go away. After trying to bear the pain for a couple hours, you call a friend who then drives you to the closest hospital emergency room. An ER doctor examines you and orders an abdominal ultrasound.

Your Premier Plus benefit for an ER visit is $500 per day. The benefit for an ultrasound is $300 per test. Once you submit your expenses, you would be paid $500 for one ER visit and $300 for one ultrasound.

The ultrasound shows the doctor your appendix needs to come out. You’re immediately taken to surgery for a successful open appendectomy.

Your Premier Plus benefit for a surgeon is $5000 for this type of surgery. The benefit for an anesthesiologist is 30% of the surgeon benefit. So, for the services of the surgeon and the anesthesiologist, you would receive $6,500 in benefits.

Post-surgery, you incur a 1-day hospital stay. You are given a prescription for some pain medication before you leave, which you fill at your pharmacy on the way home.

Your Premier Plus benefit for a hospital stay is $5,000 per day. The generic prescription benefit is $20. For the hospital stay of one day and the generic pain medication prescribed, you would receive benefits totaling $5,020.

So, after submitting all your expenses, in this example the total benefits you would receive from a Health ProtectorGuard Premier Plus plan equal $12,320.

Health care costs vary, fixed indemnity insurance benefits don't

In the appendectomy example above, it’s important to remember that you would be paid $12,320 no matter what your total cost of care was. Fixed indemnity insurance pays that set amount specified in the plan.

According to the International Federation of Health Plans, in 2015 the average cost of an appendectomy in the United States was $15,930. But they also found that 25% of the time the same procedure might cost $9,332.³ That means:

If your care for those hospital services came to $9,332, you would be paid $12,320 and get to keep the rest of the money to use however you choose
If your costs were closer to the average of $15,930, you would be responsible for the rest. However, your fixed indemnity plan would still helped with thousands in out-of-pocket costs.

Can a fixed indemnity plan help cover what your major medical plan doesn't?

In some cases, it might. Those out-of-pocket health care costs you could be helping with a fixed indemnity plan can include your major medical insurance deductible. If you have a high-deductible health plan, the fixed benefits paid as the result of a hospital stay like the one described here are really designed to help cover costs your major health insurance plan doesn’t.

How does Health ProtectorGuard work?

Video transcript

Soft music plays as an animated woman appears in a thin green circle over text.

ON SCREEN TEXT: a little

WOMAN: Sometimes you may need a little coverage.

The circle becomes darker green and the outline becomes thicker.

WOMAN: Sometimes you need a lot.

ON SCREEN TEXT: a lot

A logo appears over text. More text appears with a disclaimer.

ON SCREEN TEXT: UnitedHealthcare® Golden Rule Insurance Company

ON SCREEN TEXT: Health ProtectorGuard Fixed Indemnity Insurance Plans

WOMAN: Golden Rule Insurance Company, a UnitedHealthcare company, offers Health ProtectorGuard Fixed Indemnity Insurance Plans.

Animated documents unfold, representing different plans.

WOMAN: These plans offer a variety of benefit options so you can choose a plan that works best for you.

A plan appears beside text over a gray and white background.

ON SCREEN TEXT: works best for you

WOMAN: For example, would you prefer a plan with benefits for two doctor visits per year, or a plan that offers benefits for five doctor visits per year?

Two images of doctors overlap beside the words 2 doctor visits. The text changes to say 5 doctor visits, and five animated doctors stack up.

WOMAN: Or maybe a plan with benefits for 10 visits?

Five more animated doctors appear as the text changes to 10 doctor visits.

WOMAN: You choose.

White text appears over a blue background.

ON SCREEN TEXT: You choose!

WOMAN: Or maybe a wellness/preventive visit is more important to you.

The phrase wellness/preventive visit appears beside an animated stethoscope.

WOMAN: Our plans offer options of an annual $100, $200, or a $250 wellness/preventive care benefit.

The different dollar amounts appear beside more animated stethoscopes.

WOMAN: Do you need prescription coverage?

A prescription pill bottle appears over text, then another bottle appears. A line slashes through the bottle on the right.

ON SCREEN TEXT: with or without prescription coverage

WOMAN: There are plans available with and without prescription coverage, but every plan does include a prescription discount card where you can save 50% to 75% at participating pharmacies.

Text appears below an animated card and the amounts 50% and 75%.

ON SCREEN TEXT: prescription discount card*
*Not insurance. Discount program only.

WOMAN: With Health ProtectorGuard, you can find a plan that balances benefits with your budget.

A document balances with a dollar sign on a teeter totter.

ON SCREEN TEXT: balances benefits with your budget

Text appears in and below a green circle.

ON SCREEN TEXT: Health ProtectorGuard Fixed Indemnity Coverage

WOMAN: And since Health ProtectorGuard is fixed indemnity coverage, a doctor visit benefit of $100 will pay $100, regardless of the actual office visit charge.

An animated dollar bill appears over text.

ON SCREEN TEXT: $100 doctor visit benefit

The text slides to the side of the screen, and an animated bill for $75 appears.

WOMAN: For example, if you go to the doctor and the visit actually only costs $75, a $100 benefit is still paid, but you get to keep the remaining $25.

ON SCREEN TEXT: you get to keep $25

The text $100 doctor visit benefit reappears on the left side of the screen, and a bill for $125 appears.

WOMAN: On the other hand, if the doctor visit actually costs $125, you still get a $100 benefit, but you would simply pay the difference.

ON SCREEN TEXT: you would pay the difference

WOMAN: Each specified medical expense pays a fixed amount of cash.

Text appears under animated dollar bills.

ON SCREEN TEXT: each expense pays a fixed amount of cash

ON SCREEN TEXT: doctor visits

WOMAN: Besides doctor visits, specified medical expenses include, but are not limited to hospital stays, emergency room visits, ambulance services, surgeon fees, X-rays and lab tests, chemotherapy, and preventive care.

A list appears under the animated dollar bills.

ON SCREEN TEXT:             specified medical expenses
                                            hospital stays
                                            emergency room visits
                                            ambulance services
                                            surgeon fees
                                            X-rays and lab tests
                                            chemotherapy
                                            preventive care

WOMAN: Benefits for these individual services depend on the plan level you purchase.

A gray bar with one dollar sign on top appears beside a taller blue bar with three dollar signs.

WOMAN: Lower cost plans generally pay lower amounts. Higher benefit plans generally cost a little more.

The bars slide away to reveal text.

ON SCREEN TEXT: lower cost plans pay lower amounts

ON SCREEN TEXT: higher benefit plans cost a little more

A green Health ProtectorGuard circle appears. A blue bar stretches down the screen, separating the green circle from the words ACA coverage with a no symbol over it.

WOMAN: Whatever you choose, it's important to know that Health ProtectorGuard plans are not ACA coverage, which means it isn't considered minimum essential coverage.

A no symbol covers the words Minimum Essential Coverage.

WOMAN: We'll have some medical questions on the application because Health ProtectorGuard plans do not provide coverage for preexisting medical conditions.

A clipboard with a document appears, the words preexisting conditions replace the image, and a no symbol covers them.

WOMAN: That means if you are being treated for a medical condition or are experiencing symptoms before coverage begins, then the policy won't cover those things for a specific amount of time.

Text appears, then gets replaced by a no symbol and the words won’t cover.

ON SCREEN TEXT: treated for a medical condition

ON SCREEN TEXT: experiencing symptoms before coverage begins

WOMAN: The plan is designed to cover you if new medical issues arise during your coverage period.

Text appears on the page of a calendar.

ON SCREEN TEXT: new medical issues

Two animated women appear, one with a thin green circle around her, the other with a thicker circle. The words “a little” appear under the first one, and the words “a lot” appear under the second.

WOMAN: Health ProtectorGuard, whether you need a little coverage or a lot, choose the plan with benefit levels that work best for you.

A logo and text appear on a white background.

ON SCREEN TEXT: UnitedHealthcare® Health ProtectorGuard

Text and a disclaimer appear on a blue background below.

ON SCREEN TEXT: questions? 1•844•719•4870 Or Call Your Local Health Insurance Broker

The picture fades out.

Those benefits would most likely meet your deductible and more. They might even help you reach your health plan’s maximum out-of-pocket costs for the year.

Expand your health care options with fixed indemnity insurance

Many fixed indemnity plans provide benefits without network restrictions. Do you often travel outside of your network area? Do you have a regular doctor you trust that isn't part of your network? Indemnity health insurance expands your health care options in any situation where your main health insurance network restrictions are too tight.

Features of Health ProtectorGuard plans

The ability to apply year-round, even outside of annual Open Enrollment
Network flexibility to see any provider you wish
Cash payments to use as you see fit

Ready for some hospital and doctor fixed indemnity insurance plan options?

View plans

Add critical illness insurance or accident insurance

You can round out your coverage for unexpected health-related costs by adding:

Critical Illness insurance, which pays cash for eligible illnesses. Learn more about Critical Illness Insurance
Accident insurance, which can help you pay costs for an accidental injury. Learn more about Accident Insurance

Footnotes

THIS PLAN 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.
Benefits and limitations vary by plan. Check brochure for details.
2015 Comparative Price Report Variation in Medical and Hospital Prices by Country. International Federation of Health Plans. Retrieved from www.ifhp.com/

Disclaimers

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.

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).