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), 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:

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

1. Qualified Medical Expense Performed
2. Claim Submitted
3. 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.