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Medical Indemnity Insurance

Get affordable insurance plans with set benefits and no deductible.

This is not a replacement for health insurance or a Medicare Supplement (Medigap) insurance policy. See details below.
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Medical Indemnity Insurance: Understanding How It Works

Medical indemnity insurance is a type of health insurance that provides financial protection to policyholders against unexpected medical expenses, helping to cover costs that are not covered by standard health insurance policies. This type of insurance can help policyholders cover out-of-pocket costs associated with medical care, such as deductibles, co-pays, and coinsurance. Indemnity insurance can also provide protection against unexpected medical emergencies and catastrophic events that require extensive medical care. It is often offered as a supplemental policy to fill gaps in coverage. In this article, we will provide a more in-depth overview of medical indemnity insurance, what it covers, and potential benefits of selecting an indemnity insurance plan.

What is Indemnity Insurance?

Indemnity insurance is a type of insurance that provides financial protection to policyholders against unexpected losses. In the case of medical indemnity insurance, the policyholder is protected against unexpected medical expenses. It covers medical costs associated with an injury or illness that are not covered by traditional health insurance policies. Indemnity insurance is also known as fee-for-service insurance, meaning that the insurance provider pays a fixed amount per service rendered, regardless of the actual cost. Medical indemnity insurance policies generally have no network restrictions, which means that policyholders are not limited to certain healthcare providers or hospitals. This type of insurance also typically does not require policyholders to have a primary care physician or referrals to see a specialist.

What Does Medical Indemnity Insurance Cover?

Medical Indemnity insurance Medical indemnity insurance can cover a variety of medical expenses that are not covered by standard health insurance policies. Some of the most common expenses that are covered by medical indemnity insurance include deductibles, copayments, and coinsurance. In addition, medical indemnity insurance can cover other expenses related to medical treatment, such as transportation costs and home health care services. Medical indemnity insurance can provide coverage for a wide range of medical services, including hospital stays, surgery, and outpatient care. The exact coverage provided by a policy will depend on the specific terms of the policy, but most policies cover the following services:

  • Hospital stays
  • Emergency room visits
  • Outpatient surgery
  • Diagnostic tests (such as X-rays and MRIs)
  • Prescription medications
  • Doctor visits
  • Specialist consultations
  • Physical therapy

Policyholders can choose to purchase additional coverage to cover additional medical services or to increase their coverage limits.

Potential Benefits of Selecting an Indemnity Insurance Plan

One of the most significant benefits of selecting an indemnity insurance plan is that it provides more flexibility in choosing medical providers. Unlike managed care plans, such as HMOs and PPOs, indemnity insurance plans do not have networks of medical providers. As a result, patients can choose any doctor or hospital they want without worrying about being out of network.

Another potential benefit of selecting an indemnity insurance plan is that it can provide more comprehensive coverage for medical expenses. While traditional health insurance policies typically cover only a portion of medical expenses, indemnity insurance can cover a wider range of expenses. This can be especially beneficial for individuals with chronic conditions or those who require ongoing medical treatment.

There are several potential benefits to selecting an indemnity insurance plan. These include:

  1. Freedom to Choose Healthcare Providers: Indemnity insurance policies generally have no network restrictions, which means that policyholders can choose any healthcare provider or hospital they prefer. This gives policyholders greater freedom and flexibility in their healthcare choices.
  2. No Referral Requirements: Indemnity insurance policies generally do not require policyholders to have a primary care physician or referrals to see a specialist. This can make it easier for policyholders to get the care they need without having to go through additional administrative processes.
  3. Fixed Benefits: Indemnity insurance policies often provide fixed benefits for specific medical services, which means that policyholders know exactly how much they will be responsible for paying for each service. This can make it easier for policyholders to budget for medical expenses and plan for their healthcare needs.

Policyholders can choose to purchase additional coverage to cover additional medical services or to increase their coverage limits.

Fixed Indemnity Insurance

Fixed indemnity insurance is a type of medical indemnity insurance that provides fixed benefits for specific medical services. Unlike traditional indemnity insurance, fixed indemnity insurance policies generally provide a fixed amount of coverage for each medical service covered under the policy. Policyholders are responsible for paying any additional costs that exceed the fixed benefit amount.

Fixed indemnity insurance policies are generally less expensive than traditional indemnity insurance policies, but they also provide less comprehensive coverage. Policyholders should carefully review the terms of their policy to understand the specific benefits provided and any limitations or exclusions.

For example, a fixed indemnity insurance policy may pay out $50 for a doctor's office visit, regardless of the actual cost of the visit. Fixed indemnity insurance policies are often used to supplement traditional health insurance policies and are typically less expensive than comprehensive medical indemnity insurance policies.

Medical indemnity insurance can provide valuable protection for policyholders against unexpected medical expenses. This type of insurance can give policyholders greater freedom and flexibility in their healthcare choices, as well as fixed benefits for specific medical services. Fixed indemnity insurance policies can be a more affordable option for policyholders, but they also provide less comprehensive coverage. Before purchasing an indemnity insurance policy, it is important for policyholders to carefully review the terms of the policy to understand the specific benefits provided and any limitations or exclusions.

It can provide more flexibility in choosing medical providers and more comprehensive coverage for medical expenses. Small businesses and self-employed individuals can benefit from medical indemnity insurance policies as a way to supplement their standard health insurance policies and fill gaps in coverage. It is essential to understand what is covered and not covered by these policies and compare policies and costs before choosing a plan.

IMPORTANT: This is a fixed indemnity policy, NOT health insurance

This fixed indemnity policy may pay you a limited dollar amount if you're sick or hospitalized. You're still responsible for paying the cost of your care.

  • The payment you get isn't based on the size of your medical bill.
  • There might be a limit on how much this policy will pay each year.
  • This policy isn't a substitute for comprehensive health insurance.
  • Since this policy isn't health insurance, it doesn't have to include most Federal consumer protections that apply to health insurance.

Looking for comprehensive health insurance?

  • Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
  • To find out if you can get health insurance through your job, or a family member's job, contact the employer.

Questions about this policy?

  • For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners' website (naic.org) under "Insurance Departments."
  • If you have this policy through your job, or a family member's job, contact the employer.

Important Information About Medical Indemnity Insurance

Medical Indemnity Insurance is a different kind of health insurance that pays set cash amounts to help you affordably manage the health care needs of today versus the possible needs of tomorrow.

Medical Indemnity Insurance policies do not cover pre-existing conditions. Medical Indemnity Insurance is also not considered minimum essential coverage under the Affordable Care Act (ACA, also called Obamacare), and even if you enroll in and maintain medical indemnity coverage, you may still be subject to the tax penalty. Further information about the ACA and its implications can be found in our Affordable Care Act Resource Center.