Self-employed, contracting, between jobs, or carrying a deductible so high the plan barely functions until you have spent thousands. Fixed indemnity coverage pays cash when something happens. It is not a health plan, and this section is careful about the difference because the difference is where people get hurt.
This product does not constitute comprehensive health insurance coverage (often referred to as, “major medical coverage”). Therefore, this product does not satisfy the requirement of Minimum Essential Coverage under the Federal Patient Protection and Affordable Care Act. For additional information, you can contact us, refer the official federal website at www.healthcare.gov, or call their toll-free number at 800-318-2596.
Fixed indemnity coverage pays set cash amounts when specific things happen — a night in hospital, a surgery, an emergency room visit. It does not pay a share of your bill and it does not cap what you can owe. If you can get comprehensive coverage through an employer, through the Health Insurance Marketplace or through Medicaid, that is a better product than this one and you should look at it first. This exists for the people who fall between those.
These are not our products and we are not paid if you take one. Price them before you price anything on this page.
Subsidies on HealthCare.gov reach further than most people expect, and they changed again recently. A comprehensive plan covers what this does not — an ongoing condition, a long illness, the whole of a catastrophic bill — and it caps what you can be made to pay in a year. If you qualify for one at a price you can manage, take it. If you have had a life change such as losing a job, getting married or having a baby, you can enrol outside open enrolment. We would rather you found that out on this page than after buying something from us.
It pays a fixed amount for each covered event, set out in the schedule before you buy. A night as an inpatient pays the same whether the hospital billed four thousand or forty. That is the whole design, and it is both the strength and the weakness: the money arrives without an argument about what was reasonable, and it stops at the scheduled amount however large the real bill is.
It will not cap your exposure. There is no out-of-pocket maximum behind it, because it is not that kind of product. It does not satisfy any requirement to carry health insurance. It is not a replacement for a plan that covers a chronic condition, and it does not pay a percentage of anything. Anybody who sells it to you as equivalent to a health plan is either confused or lying to you.
People with no realistic route to comprehensive coverage, and people who already carry a high-deductible plan and want something that pays cash before the deductible is met. In the second case it works alongside the health plan rather than instead of it, which is the most defensible use of the product.
The policy comes bundled with telemedicine, prescription discounts, discounted lab and imaging work, and a health advocacy service. Those are provided by other companies, they are not part of the policy, and they are not insurance. A monthly administration fee for them is already inside the premium shown. They are useful; they are not coverage, and no claim is paid by them.
No. The carrier's own notice says so in terms: it does not constitute comprehensive health insurance coverage and does not satisfy the requirement of Minimum Essential Coverage under the Affordable Care Act. That notice is reproduced in full on every page of this section. If you need coverage that counts, HealthCare.gov is where to look.
Yes, and for a lot of people that is the sensible version. Fixed indemnity pays its schedule regardless of what your health plan pays, so on a high-deductible plan it can cover the part you would otherwise fund yourself. Nothing is offset and there is no co-ordination between the two.
The base plan pays its schedule and then stops at the calendar year and lifetime limits. The optional Specified Disease Rider is what exists for the catastrophic case — it covers a defined list of conditions above a deductible you choose. It is separately underwritten, carries a pre-existing condition period, and is not available in every state. Both the list and the limits are on the product page.
Issue ages are 18 to 64, and this is fully medically underwritten — not guaranteed acceptance. The application asks about surgery in the last five years, any doctor seen in the last twelve months, any medication prescribed in that time, and a long list of named conditions. It takes your height, weight and your physician's details, and authorises the company to pull your medical records, prescription history and MIB file. The rider is underwritten more tightly again. If you have something significant in your history, tell us early and we will give you a straight read rather than let you find out at application.
No. No form on this site asks about a condition, a medication or a diagnosis, and the free-text box tells you to leave them out. The carrier's application does ask them, in detail, because it is underwriting the risk — that happens between you and ManhattanLife on its own form, not here.
The application is declined. That applies if the applicant or any dependent under 26 is currently pregnant or in the process of adopting a child, whether or not that person is the one applying. It is worth knowing before you spend time on it.
No. Treatment received outside the United States is excluded, and so are drugs or medicines obtained from outside it. If you travel or spend part of the year abroad, raise that first — it is on the list of things we tell you to get in writing before signing.
Moving down is easy: any time, no further underwriting. Moving up means being underwritten again and can only happen on your policy anniversary. If you are between two plan levels and healthy now, that asymmetry is worth a minute's thought.
Because it is the right answer for a lot of the people who land on this page, and because an agency that only tells you about the products it sells is not worth listening to on the ones it does not. We are paid when you buy from us. Knowing that, you should weigh what we say about the alternative — so we have linked it rather than described it.
Tell us your state and roughly what you are dealing with. If a Marketplace plan is the better answer for you we will say so — it costs us nothing to be straight about that and it costs you a great deal if we are not.