Hospital and Doctor Insurance
Health ProtectorGuard Fixed Indemnity Insurance
Hospital and doctor fixed indemnity insurance is also often called fixed-benefit insurance or fee for service insurance. That’s because this type of insurance pays you a set—that is, fixed—amount of money for specific services covered by the plan.
Apply benefit payments toward your other health plan's deductible
Get cash to help meet prescription drug copays
Help pay your share of lab or diagnostic costs, like for blood tests or X-rays
Have money for those unforeseen expenses surrounding a planned or an unplanned surgery
Unexpected medical bills can disrupt even the healthiest home budgets. Health ProtectorGuard1, underwritten by Golden Rule Insurance Company, is a fixed-benefit insurance plan that can help you deal with the unexpected by paying you or your provider a preset benefit amount for some of the most common medical costs you and your loved ones might face.
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With a Health ProtectorGuard indemnity plan:
- You are paid regardless of other insurance coverage.
- You don’t have to meet a deductible before you receive benefits.
- Your fixed benefits are paid straight to your provider or to you after a covered expense is submitted.
- You choose the doctor or health facility you need.2
- You can apply year round, not just during an enrollment period or because of special circumstances.
What is indemnity insurance?
A fixed indemnity plan like Health ProtectorGuard is much different than a major medical insurance plan.
A regular major medical health insurance plan pays for all or a percentage of covered expenses after you meet a deductible, pay a copay or reach a certain amount of out-of-pocket costs. Put simply, for qualified expenses, in most cases, you pay first, and then your insurance company covers the rest.
A fixed indemnity plan offers limited benefits and is meant to supplement a more traditional health insurance plan. Indemnity insurance essentially flips how you are paid when compared to major medical insurance. You or your provider are paid a predetermined fixed benefit for certain health care expenses you have incurred, and then you are on your own for the rest.
Fixed indemnity insurance is not major medical insurance and does not provide the mandated coverage necessary to avoid a penalty under the Affordable Care Act (ACA). It does not provide coverage for all the essential health benefits outlined in the ACA. It will most likely not provide coverage for expenses resulting from preexisting medical conditions.
What are the features of a Health ProtectorGuard insurance plan?
In addition to the set amount of money paid for receiving specific medical services, Health ProtectorGuard is designed with enhanced features to make the plan helpful just when you may need it most.
Note: No insurance plan covers everything. The Health ProtectorGuard product brochure has more detailed information to help you decide if this coverage will work for you.
Features for doctor/urgent care visits
- Some Health ProtectorGuard fixed indemnity plans allow you to rollover unused doctor office/urgent care visits (up to a maximum of five visits) in those years you don't need them.
- Health ProtectorGuard features preventive care benefits for visiting the doctor to stay healthy, like to get a physical or a mammogram, not just when you feel ill.3
- The Health ProtectorGuard second surgical opinion feature can help you seek out additional medical advice about potential surgery.
Features for hospitalization
- Health ProtectorGuard features unlimited inpatient hospital confinement and surgical benefits, which means no matter how long you stay in the hospital or how many surgeries you have, you may receive benefits.4
- Set payment for injury-related hospitalization increases 25% for every year up to the fifth year you keep your Health ProtectorGuard fixed indemnity plan.
- Health ProtectorGuard fixed indemnity insurance recognizes some surgeries are more complex and expensive. It pays more for certain surgeries and may include additional payment when an assistant surgeon is involved.
- If a hospital stay involves the intensive care or critical care unit, payment for that stay is made in addition to the daily inpatient hospital confinement benefit. That's more cash to deal with more serious hospitalization costs.
Saving now and later
- Take advantage of network discounts — You have no network restrictions with Health ProtectorGuard. You can go to any doctor or health care facility you want and still get your eligible benefits. However, you also have access to discounted rates for services if you use doctors or providers in the MultiPlan Limited Benefit Plan network. (Note: There’s a $3.25 MultiPlan network access fee included in addition to your premium each month.)
- There are no deductibles, no application or association fees to pay.
- Use your prescription drug discount card — Every plan comes with a card that helps you get drug discounts of up to 50 to 75% off.5
- In most cases, Health ProtectorGuard fixed indemnity insurance is renewable up to age 65.
How do I use my Health ProtectorGuard insurance?
It’s simple. You or your provider just submit a covered expense. The fixed benefit for that eligible service is then paid, regardless of other insurance coverage.
Benefits vary by plan. Check brochure for details.
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.
2 If you have a major medical plan, remember that you may need to stay with certain networks and providers to get the most coverage out of that plan. Take that into consideration when choosing where you get your care.
3Available after a 6-month waiting period in most states. Check brochure for details.
4Intensive care or critical care hospitalization benefits are subject to a 31- or 60- day maximum per confinement. If more than one surgery occurs during any given day, the highest tiered amount is paid. Check brochure for details.
5Drug discount card is for prescription discounts only. This is not insurance.
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.
Each company is a separate entity and is not responsible for another's financial or contractual obligations.
Administrative services are provided by United HealthCare Services, Inc. or their affiliates.
Products and services offered are underwritten by Golden Rule Insurance Company, Health Plan of Nevada, Inc., Oxford Health Insurance, Inc., UnitedHealthcare Life Insurance Company, UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of New York, Inc.
This policy is subject to various exclusions and limitations. For costs, complete details of the coverage, and terms under which the policy may be continued in force or discontinued, call (or write) your insurance agent or the company (whichever is applicable).