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SUPPLEMENTAL PLANS

Hospital and doctor insurance - Fixed indemnity plans

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Health ProtectorGuard – Golden Rule Insurance Company

What is indemnity insurance?

 

Fixed indemnity insurance, like Health ProtectorGuard plans, helps take some of the worry out of budgeting for medical expenses by helping you pay for things like doctor office visits, prescriptions, and hospital stays even before you've met your main health insurance deductible. It pays fixed benefits for services covered by the plan no matter where you get care and regardless of other insurance payments.F10

And because Health ProtectorGuard plans are available all year round, you can apply for a Health ProtectorGuard plan today.

No deductible to meet

1st dollar coverage - a fixed benefit is paid for covered expenses once the expense is submitted. No deductibles!

Go anywhere for care

No restrictions on where you get care. Benefits pay set amount regardless of what doctor or facility you use.

100% of benefit

100% of benefit for covered cost is paid regardless of other insurance coverage or what the service actually cost.

 

Why Health ProtectorGuard – Golden Rule Insurance Company

Who is a Health ProtectorGuard plan for?

The supplemental health insurance coverage provided by Health ProtectorGuard is for anyone who could use a little help when those unexpected medical expenses pop up. Plans have no deductible to meet and most benefits have no waiting period, which means your benefits for most covered expenses start day one of your plan.

Self-Employed

Or gig worker

Need Extra Coverage Now

Apply year round

Have High Deductible

Or other out-of-pocket costs

Worried about Surprise Bills

Like from a hospital stay or ambulances

 

Have Out-of-Network Costs

Helps wherever you get care

 

Choosing the Right Plan

How will you use your Health ProtectorGuard plan?

A Little Help

For the lowest Health ProtectorGuard premium, a Choice plan with WORx (Wellness, Office Visit, and Rx - Prescription) Level 1 benefits offers straightforward set cash benefits in many health service areas you need, like hospital stays and surgeries, doctor and urgent care visits and more.

Recommended Plan: HPG Choice 1

Office/Urgent Care Visits

If visits to the doctor are common for you, choose WORx (Wellness, Office Visit, and Rx - Prescription) Level 3 with the most office visits and highest office visit benefits Health ProtectorGuard offers.  WORx Level 3 paired with a Select plan for hospitalization benefits may be a good fit. 

Recommended Plan: HPG Select 3

Just in Case

The highest per day hospital stay benefit. The highest intensive care unit stay benefit. The most benefits paid for emergency room visits and outpatient surgical facilities. Health ProtectorGuard Premier plans with WORx (Wellness, Office Visit, and Rx - Prescription) Level 3 benefits can help when the unexpected happens.

Recommended Plan: HPG Premier 3

 

Health ProtectorGuard Options – Golden Rule Insurance Company

 

Options for supplemental indemnity coverage

 

Take a glance at the benefits & compare hospital and doctor indemnity insurance plans

 

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), or Obamacare, 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:

  • A deductible, an amount you have to pay before insurance will pay benefits
  • A percentage of covered expenses you have to pay even after you’ve met your deductible, what’s called coinsurance
  • Or a fixed fee, a copay, that you owe for a particular medical service

Regardless, your health insurance plan comes with costs built in that you are responsible for paying.

Fixed indemnity insurance is designed to be a supplemental plan that helps with some of those costs by paying a set amount of money for certain qualified expenses. That money can help pay down a deductible or cover a copay or coinsurance amount.

In short, it can help you manage the out-of-pocket costs that inevitably come with your medical insurance plan.

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.


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