Fixed Indemnity Insurance
What is Fixed Indemnity Insurance?
Fixed Indemnity Insurance is a form of health insurance that pays a fixed amount either per incident or period. The amount paid does not change based on the total charges of the doctor or medical professional.
For example, a plan might pay $1,000 when a covered party is admitted to the hospital plus up to $1,000 per day while they remain in the hospital.
How is Fixed Indemnity Insurance Different from HMOs and PPOs?
The insurance company generally pays your healthcare providers and hospitals directly in an HMO or PPO. With fixed indemnity insurance, you are paid directly for covered benefits. Paid via direct deposit, you can use these benefits however you see fit.
Additionally, fixed indemnity policies do not require deductibles, coinsurance, or copays. You are not limited to a network as you would be with most HMOs or PPOs.
Is Fixed Indemnity Insurance Used Instead of or in Addition to HMOs or PPOs?
That’s up to each person to decide. When the Affordable Care Act (ACA) was passed, it specified that Fixed Indemnity Insurance would be exempt from the rules of ACA only if the policy benefits were paid on a per-period basis – and would not be exempt if they were paid on a per-service basis.
In 2014, the rules were relaxed to also allow for per-service payments – but only if the person who was covered had minimum essential coverage in addition to their fixed indemnity policy.
In 2016, health insurers and more than ten states took legal action, and the federal appeals court struck down this requirement. Today, there are no restrictions on who can apply for Fixed Indemnity Insurance, and you are not required to have additional coverage to be eligible.
Who is Fixed Indemnity Insurance Right For?
There are two main categories of people who choose fixed indemnity insurance: those who have additional insurance and those who choose fixed indemnity as their primary insurance.
Adding Fixed Indemnity Insurance in Addition to an Existing Policy
Those who choose to add this coverage often want to visit specialists or doctors outside of their network. Others have high deductibles on their primary coverage and want the additional coverage that comes with fixed indemnity insurance.
Remember, the money paid out in benefits can be used for any purpose. As a result, some people use it to cover expenses that occur due to missing work after an illness or accident, paying for childcare while they are in a doctor’s appointment, or paying for medications that are not covered by their primary insurance.
Using Fixed Indemnity Insurance in Place of Health Insurance
There are those who have no other health insurance and do not want to pay the hefty premiums that come along with it, yet they do not want to risk having no coverage. Fixed indemnity is a middle-ground that can be more comfortable.
These are flexible and easy plans to sign up for and cancel. Unlike traditional health insurance that only allows for sign-ups or changes during an open enrollment period, you can sign up for or cancel these plans at any time you would like.
What Does Fixed Indemnity Insurance Cover?
That depends on the plan you choose. Generally speaking, you can expect the following to be covered to some extent.
What Are the Limits to Fixed Indemnity Insurance?
It’s essential to have all the facts to decide if this is the right choice. First, know that this coverage is not included in the ACA and, therefore, will not prevent a tax penalty for not having health insurance.
Second, you do not have some of the protections the ACA provides. For example, fixed indemnity insurance is not required to cover pre-existing conditions and can have annual lifetime limits.
Note that there are some states in which HealthGuard is not available, and you cannot be enrolled in a federal or state-funded health care program such as Medicare or Medicaid. It is also not an option for active, full-time members of the Armed Forces.
AWA HealthGuard
AWA HealthGuard provides access to Fixed Indemnity Insurance for eligible members. This coverage pays a per-day or per-event fixed amount when members are injured in covered accidents or are struck with a covered illness.
There are various coverage types and options available to ensure each member can find the level of coverage they need within their budget.
AWA EliteHealth
When it comes to our health, life can throw a lot of curve balls. So, when an illness arises, worrisome symptoms may appear or the unexpected happens, AWA EliteHealth can help. The insurance benefits that come with this membership may help offset the expenses incurred with a covered sickness, condition or accident. And, with included physician office visits and a fully insured, outpatient generic prescription drug benefit, AWA EliteHealth provides additional tools to help members manage the out-of-pocket costs that can quickly add up with an illness or injury.
Are AWA Memberships with Fixed Indemnity the Right Option for You?
If you are at least 18 and under the age of 65, a legal resident of the United States, and either a small business owner, self-employed professional, entrepreneur, or contractor, and a member of the Affiliated Workers Association, then you are likely eligible for AWA HealthGuard or EliteHealth. Coverage is available for domestic partners and dependent children until they reach their 26th birthday.
If you are looking access to affordable, flexible insurance that can relieve financial strain caused by illnesses and accidents, then this could be the right choice for you. For any further questions about AWA HealthGuard, AWA EliteHealth and fixed indemnity insurance, please contact us. We’re happy to help!