Health ProtectorGuard hospital and doctor insurance: frequently asked questions (FAQs)

Fixed Indemnity plans1

What is indemnity insurance?

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.

Is Health ProtectorGuard like Affordable Care Act (ACA) health 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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How do I receive my benefits?

After you have a qualified medical expense under the Health ProtectorGuard plan, you submit a claim. You are then paid a predetermined amount for that covered service as detailed in the plan. You don’t have to pay a deductible first, and it doesn’t matter if you have other insurance covering the same expense. The money from this plan is fixed and comes directly to you to use as you want.

  1. Receive care for a qualified medical expense
  2. Submit a claim
  3. Receive a check to use any way you see fit

What do I have to pay before I get a benefit from the plan?

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, your benefit is paid after you submit your claim.

When can I file a claim?

Right after a qualified expense. Once you have received services for expenses that are covered by your hospital and doctor fixed indemnity plan, you send in a claim. You are then paid the preset amount.

Why would I buy indemnity insurance?

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 supplements your health insurance by paying you a set benefit for certain qualified expenses. You can then use that money to help meet some of these out-of-pocket costs you are responsible for under your medical plan.

Check out options to get cash back for qualifying medical expenses.

Learn more about fixed indemnity insurance

If my health insurance plan covers me for something, will the fixed indemnity plan still pay?

Yes. There are no coordination of benefits conflicts with your fixed indemnity insurance. It pays you for the covered expense regardless of overlap from what other health insurance you have might cover.

Am I confined to a narrow network of doctors or hospitals?

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.

Learn about Health ProtectorGuard Fixed Indemnity Insurance

How Health ProtectorGuard Works

Key terms to help you understand Health ProtectorGuard features

Some fixed indemnity insurance plans feature an alternative form of deductible. In exchange for a smaller premium payment up front, you can agree to reduce the amount of the fixed benefits paid to you. In other words, you don’t pay the deductible. Instead, you agree to receive less benefit payment. Check specific plans for details.

While you may have the option of visiting the doctor or provider of your choice with fixed indemnity insurance, some plans offer additional savings if you do decide to visit an in-network provider.

Still need health insurance?

Short term health insurance underwritten by Golden Rule Insurance Company can help you fill your health coverage gap.

Footnotes

  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.

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 All Savers Insurance Company, Golden Rule Insurance Company, Health Plan of Nevada, Inc., Oxford Health Plans (NJ), Inc., UnitedHealthcare Benefits Plan of California, UnitedHealthcare Community Plan, Inc., UnitedHealthcare Insurance Company, UnitedHealthcare Life Insurance Company, UnitedHealthcare of Colorado, Inc., UnitedHealthcare of Alabama, Inc., UnitedHealthcare of Arkansas, Inc., UnitedHealthcare of Florida, Inc., UnitedHealthcare of Georgia, Inc., UnitedHealthcare of Kentucky, LTD., UnitedHealthcare of Louisiana, Inc., UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of the Midlands, Inc., UnitedHealthcare of the Midwest, UnitedHealthcare of Mississippi, Inc., UnitedHealthcare of New England, Inc., UnitedHealthcare of New York, Inc., UnitedHealthcare of North Carolina, Inc., UnitedHealthcare of Ohio, Inc., UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of Pennsylvania, Inc., Unitedhealthcare of Washington, 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).