Fixed indemnity insurance
Fixed indemnity insurance provides a predetermined cash payout for specific medical events or covered services regardless of actual medical costs. Insurers typically offer fixed indemnity policies as supplemental coverage to major medical plans, not as substitutes.
Policyholders receive set payments for claims such as $100 per doctor visit, $1,000 per day of hospitalization, or $50 per prescription filled. Most fixed indemnity plans exclude comprehensive benefits like preventive care or chronic disease management, citing limitations in policy documents.
Consumers use payouts from fixed indemnity insurance to help cover out-of-pocket expenses such as deductibles and copayments. Major carriers offering fixed indemnity insurance include Aflac, UnitedHealthcare, and Colonial Life according to NAIC 2022 filings.
Premiums for fixed indemnity plans generally range from $25 to $75 monthly for individuals based on industry surveys. State regulators classify fixed indemnity insurance as an excepted benefit under the Affordable Care Act (ACA), so policies do not meet minimum essential coverage requirements.
Claims frequency under fixed indemnity insurance can be higher than standard health insurance due to low-cost payout triggers, per Milliman analysis, according to a report from Your Insurance Info. Typical policy exclusions include pre-existing conditions, pregnancy-related care, and elective procedures found in sample contracts reviewed by NAIC.
Fixed indemnity insurance is non-coordinated with primary health coverage; insurers pay benefits directly to enrollees without considering other reimbursements.
What is fixed indemnity insurance?
Fixed indemnity insurance is a type of health insurance plan that provides coverage up to a predetermined dollar amount for specific services. This coverage is typically provided on an annual or per-visit basis and does not take into account any deductibles, co-payments, or coinsurance the insured may be responsible for. It usually covers doctor visits,…
Is fixed indemnity insurance good?
Fixed indemnity insurance is an affordable and flexible option for those looking to protect their finances in the case of unexpected events. It provides a predetermined amount of money for covered services, regardless of actual expenses incurred. It has reduced paperwork compared to other forms of insurance coverage since it does not require medical claims…
See also Fixed premiums.