Fixed Indemnity Insurance is a form of health insurance that pays a fixed amount either per period or per service. 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.
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 – to help cover bills or out-of-pocket costs you may have.
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.
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.
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.
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.
There are those who can’t pay the hefty premiums that come along with traditional health solutions, 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 if needed. 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.
That depends on the plan you choose. Generally speaking, you can expect the following to be covered to some extent.
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 is not considered major medical insurance, 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 AdvancedHealth 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 AdvancedHealth 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.
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 AdvancedHealth. 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 AdvancedHealth and fixed indemnity insurance, please contact us. We’re happy to help!