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SUPPLEMENTAL PLANS

Hospital and doctor insurance - Fixed indemnity plans

Overview
Who It's For
Plans

Health ProtectorGuard – Golden Rule Insurance Company

What is indemnity insurance?

Fixed indemnity insurance, like Health ProtectorGuard plans, helps take some of the worry out of budgeting for medical expenses by helping you pay for things like doctor office visits, prescriptions, and hospital stays even before you've met your main health insurance deductible. It pays fixed benefits for services covered by the plan no matter where you get care and regardless of other insurance payments.¹

And because Health ProtectorGuard plans are available all year round, you can apply for a Health ProtectorGuard plan today.

No deductible to meet

1st dollar coverage - a fixed benefit is paid for covered expenses once the expense is submitted. No deductibles!

Go anywhere for care

No restrictions on where you get care. Benefits pay set amount regardless of what doctor or facility you use.

100% of benefit

100% of benefit for covered cost is paid regardless of other insurance coverage or what the service actually cost.

Looking for more assistance? Call us for Help!

A fixed indemnity plan, like Health ProtectorGuard underwritten by Golden Rule Insurance Company, is one that pays a predetermined amount of money for any qualified medical services you receive. So, for example, if your plan specifies a $50 per day benefit for X-rays and you break your arm and have to get an X-ray, the plan pays $50.

No. A fixed indemnity plan is not an Affordable Care Act (ACA), or Obamacare, health plan.

It is not major medical insurance. It does not provide coverage for all the essential health benefits outlined in the ACA. Unlike an ACA plan, it will not provide coverage for expenses resulting from any preexisting medical conditions. Read your plan carefully to see what is and what isn’t covered.

Fixed indemnity insurance provides limited benefits. It pays a certain amount per covered service up to a calendar-year or lifetime maximum.

All health insurance plans have out-of-pocket costs you, the insured, have to pay. It might be:

A deductible, an amount you have to pay before insurance will pay benefits
A percentage of covered expenses you have to pay even after you’ve met your deductible, what’s called coinsurance
Or a fixed fee, a copay, that you owe for a particular medical service

Regardless, your health insurance plan comes with costs built in that you are responsible for paying.

Fixed indemnity insurance is designed to be a supplemental plan that helps with some of those costs by paying a set amount of money for certain qualified expenses. That money can help pay down a deductible or cover a copay or coinsurance amount.

In short, it can help you manage the out-of-pocket costs that inevitably come with your medical insurance plan.

You’re familiar with your major medical insurance plan, which pays for all or a percentage of covered expenses after you meet certain deductibles, copays or out-of-pocket costs. And often, the payments the insurance company makes for you are made directly to health care providers. You see them later on in an explanation of benefits form.

Indemnity insurance payment works differently. It pays a certain predetermined amount for health care expenses specified in the plan. There are no deductibles to meet. Once a claim for a qualified expense is submitted, the amount the plan specifies for that service is paid. The money is fixed and is paid regardless of benefits that may be paid from other insurance.

Steps in Using Indemnity Insurance

Qualified Medical Expense Performed
Claim Submitted
Set Benefit Paid

As soon as there's a qualified service performed, the doctor or facility, or in some cases you, will submit a claim for that service. The preset amount for that service will then be paid. If the preset amount doesn't cover the total bill, you are responsible for what's left. However, if there's any benefit money left after the service is paid in full, you receive that remaining amount.

Yes, you can see your own doctor. No, you don’t have to stay in a particular network of doctors or providers. You are paid a fixed amount for certain services, so where you get those services is up to you.

Important: Your fixed indemnity plan won’t have network limitations, but your major medical plan often will. To get the most coverage out of your insurance, keep your main health insurance plan’s network in mind.

Beyond what you pay to have the plan, what the insurance company calls your premium, no. Fixed indemnity insurance has no deductible or copay you have to meet first. If you or your provider claim a qualified service, the set benefit is paid. Remember, though, if the set benefit doesn't cover the total expense, you are still responsible for what's left.

Yes, you will.

This is called a coordination of benefits issue, when the coverages from two separate insurance policies overlap. With your fixed indemnity insurance, there is no coordination of benefits conflict. It pays the fixed benefit for the covered expense regardless of whether another insurance plan you have is also paying toward that same expense.

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Need help finding a health plan that fits? Call one of our licensed insurance brokers at. 1-800-273-8115.

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Also of Interest:

How Does A Fixed Indemnity Plan Work? Learning About Fixed Indemnity Insurance What Are Fixed Indemnity Plans?

¹THIS 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.

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Hospital and doctor insurance - Fixed indemnity plans

What is indemnity insurance?

Health ProtectorGuard Fixed Indemnity Insurance Costs | UnitedHealthOne

No deductible to meet

Go anywhere for care

100% of benefit

Health ProtectorGuard Brochure

Health ProtectorGuard Brochure – Guard Plans

A Little Help

Office/Urgent Care Visits

Just in Case

HPG Premier 1

HPG Premier 2

HPG Premier 3

Choice Value

Choice Plus

Select Value

Primary Preferred

Select Preferred

Premier Plus

HPG Choice 1

HPG Choice 2

HPG Choice 3

HPG Select 1

HPG Select 2

HPG Select 3

HPG Preferred 1

HPG Preferred 2

HPG Preferred 3

HPG Premier 1

HPG Premier 2

HPG Premier 3

Choice Value

Choice Plus

Select Value

Primary Preferred

Select Preferred

Premier Plus

HPG Choice 1

HPG Choice 2

HPG Choice 3

HPG Select 1

HPG Select 2

HPG Select 3

HPG Preferred 1

HPG Preferred 2

HPG Preferred 3

HPG Premier 1

HPG Premier 2

HPG Premier 3

How does indemnity insurance work?

Is fixed indemnity insurance ACA or major medical insurance?

Is indemnity insurance worth it?

How are the benefits paid?

How are claims submitted?

Can I see my own doctor? Do the plans have network requirements?

Do I have to pay anything before plan benefits are paid?

If my health insurance plan covers an expense, will I still get the benefits from my indemnity plan?

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