1. Fixed Indemnity Insurance — What It Is
Our plans are fixed indemnity (also called fixed benefit) insurance. This is fundamentally different from major medical insurance. Here is how:
|
Major Medical (ACA) |
Fixed Indemnity (Our Plans) |
|
Pays a percentage of your bill |
Pays a fixed dollar amount per benefit amount |
|
Subject to deductibles, copays, coinsurance |
Deductible applies ONLY for 24+ hour hospital stays |
|
Complex EOBs and surprise bills |
You know exactly what pays before you go — and our advocacy team ensures you use your benefits correctly. Without an advocacy team like ours, clients on other indemnity plans in the private market can experience significant out-of-pocket exposure. |
|
Restricted networks, referrals often required |
Use any doctor — and unlike many other indemnity plans on the market, our plan includes the First Health LBP PPO network, which means clients get pre-negotiated discounted rates when they use in-network providers. This is a meaningful difference between our plan and others in the private market. |
|
Premiums $600–$1,200/month per adult (unsubsidized) |
Premiums typically $200–$500/month |
|
Annual out-of-pocket maximums apply |
$500,000 Calendar Year Maximum per person |