Four plan levels, with cash benefits for hospital stays, surgery, emergency rooms, doctor visits, prescriptions, labs and imaging — paid per event, at amounts you can read before you buy. Plus an optional rider for the catastrophic case.
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.
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.
This is fixed indemnity insurance for ages 18 to 64. It pays set amounts for covered events regardless of what you are charged, and it is not a substitute for a comprehensive health plan. If you can get one — through an employer, through the Health Insurance Marketplace at healthcare.gov, or through Medicaid — look at that first.
The full benefit table is below, transcribed from the carrier's brochure. Each line says what happens and what it pays on each of the four plans. Nothing is left to be worked out at claim time against what a provider decided to charge, because the amount does not depend on the charge.
Elite Plus down to Classic cover broadly the same list of events; what moves is the amount on each line and a few of the annual caps. That makes the choice unusually simple for insurance: work out what a bad year would cost you, read the inpatient and surgery lines, and pick the level that closes enough of that gap to be worth the premium.
For injury-related hospital stays the inpatient benefit steps up 25% a year in years two through five. It is a reason to hold the policy before you need it rather than after, and it is one of the few features here that rewards staying put.
The base plan pays its schedule; the rider pays above a deductible you choose, for a defined list of serious conditions, up to a calendar year maximum. It behaves more like major medical than the base plan does. It is underwritten separately, carries a pre-existing condition period, and is not available in every state we are licensed in — the list is below.
These are not our products and we are not paid if you take one. Price them before you price anything on this page.
Every figure below is transcribed from ManhattanLife The Affordable Choice Enhanced brochure AFC7010-BR 1025, with underwriting and policy terms from ManhattanLife Hospital Indemnity Application AS7006AP. Benefits, riders and amounts vary by state, and the policy issued to you governs.
Paid for each inpatient day. Elite Plus $6,000, Elite $4,000, Classic Plus $3,000, Classic $2,000.
Inpatient hospital confinement and the building benefit share a $1,000,000 calendar year limit.
For injury-related hospital stays the inpatient benefit increases 25% each year in years 2 to 5. On Elite Plus that is $7,500, $9,000, $10,500 and $12,000 a day; on Elite $5,000, $6,000, $7,000 and $8,000; on Classic Plus $3,750, $4,500, $5,250 and $6,000; on Classic $2,500, $3,000, $3,500 and $4,000.
Paid for the first inpatient day per calendar year. Elite Plus $3,000, Elite $2,000, Classic Plus $1,000, Classic $1,000.
First 24 to 47 hours in an observation unit: Elite Plus $3,000, Elite $2,000, Classic Plus $1,500, Classic $1,000 per day. 48 hours or more: Elite Plus $4,500, Elite $3,000, Classic Plus $2,250, Classic $1,500 per day.
Elite Plus and Elite $300 per day, 2 days per calendar year. Classic Plus and Classic $250 per day, 1 day per calendar year.
Elite Plus and Elite $300 per day, 4 days per calendar year. Classic Plus and Classic $250 per day, 2 days per calendar year.
Daily surgical benefits for both inpatient and outpatient surgery, paid as a multiple of a scheduled amount: Elite Plus 3 times, Elite 2.5 times, Classic Plus 2 times and Classic 1 time the scheduled amount.
The reimbursement schedule for one unit is similar to what is payable under the Medicare Physician Fee Schedule for surgeries. Maximum benefit $50,000 per calendar year.
Where outpatient surgery is performed in an ambulatory surgical centre or outpatient hospital facility, the surgical and anaesthesia benefits are paid in addition to a per-day facility benefit of Elite Plus $3,000, Elite $2,500, Classic Plus $2,000, Classic $1,000.
The assistant surgeon benefit pays 20% of the eligible surgical benefit and the anaesthesiologist benefit pays 25%, on every plan.
Elite Plus $200 a day for 10 days a calendar year, Elite $175 for 10 days, Classic Plus $125 for 8 days, Classic $75 for 6 days.
A rollover provision allows a five-visit carryover per policy year.
Elite Plus $75 a day, Elite $50, Classic Plus $50, Classic $25.
$750 calendar year maximum.
Colonoscopy: Elite Plus and Elite $600, Classic Plus and Classic $500. Pap and PSA: Elite Plus and Elite $300 each, Classic Plus and Classic $250 each. Paid per service.
Surgical pathology per day: Elite Plus and Elite $300, Classic Plus and Classic $200. Other laboratory services $50 a day on every plan.
Physical, occupational and speech therapy, per day. Elite Plus and Elite $75, Classic Plus and Classic $50.
Per day, for MRI, PET scan, CT scan, mammogram and other radiology tests. Elite Plus $700 / $700 / $700 / $300 / $250. Elite $600 / $600 / $600 / $300 / $250. Classic Plus $500 / $500 / $500 / $250 / $200. Classic $300 / $300 / $300 / $250 / $200.
All outpatient benefits together are limited to $8,000 a calendar year on Elite Plus, $6,000 on Elite and $4,000 on Classic Plus and Classic.
$150 for ground ambulance and $1,500 for air ambulance, on every plan.
Limit of 2 daily benefits per calendar year for all ambulance transportation. In Michigan only one per-day benefit is paid per day regardless of how many trips are made.
Child only. $10 a day for allergy shots and $25 for immunisations, on every plan.
$100 calendar year maximum. Immunisation does not apply in Michigan.
Pays for radiation, chemotherapy and immunotherapy per day, up to 40 days per calendar year. Elite Plus and Elite $2,000, Classic Plus and Classic $1,000.
$5,000,000.
Moving down to a plan with lower benefits can be done at any time and needs no further underwriting. Moving up to a plan with higher benefits requires underwriting again and can only be done on the policy anniversary.
Adds up to $500,000 of additional calendar year coverage for a defined list of catastrophic conditions: amputation, ALS, angioplasty, internal cancer, coronary artery bypass surgery, end stage renal failure, heart attack, heart valve surgery, implantable cardiac defibrillator, joint replacement, major organ failure or transplant, pacemaker implant, ruptured aneurysm, and ischemic or hemorrhagic stroke. Four deductible options — $25,000, $50,000, $75,000 and $100,000 — against a calendar year maximum of $250,000 or $500,000, with a lifetime maximum of $2,000,000.
Not available in California, Colorado, Indiana, New Mexico, Ohio, Texas, Utah, Washington. The insured pays the deductible to the provider; above it the carrier pays the remainder of the claim to the provider. A pre-existing condition period applies for the first 12 months. The rider is underwritten separately and being declined for it does not affect the base policy. It is not available on child-only coverage.
None of these appear in the sales brochure, and each changes what the policy is worth to you. Ask for them in writing, in the policy and the outline of coverage for your state, and do not take our word or anyone else's for it.
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.
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE.
THIS POLICY PROVIDES LIMITED BENEFITS.
The plans shown above are limited benefit fixed-indemnity plans and benefits are per Covered Person. This is not a major medical insurance plan. Fixed-indemnity benefits are provided for hospital confinement and specified medical and surgical events. These benefits are paid in daily amounts for covered events without regard to the costs of services rendered. This plan does not provide expense reimbursement for charges based on your health care provider's statement.
Benefits and riders may vary by state and may not be available in all states. This is not a complete disclosure of plan qualifications and limitations. The amounts of benefits provided depend on the plan selected. Premiums will vary according to the selection made.
Network and prescription drug are not part of this policy. First Health Network and RxEDO are value added healthcare programs from other providers designed to enhance your healthcare experience without additional cost to you.
| Who is covered | Elite Plus | Elite | Classic Plus | Classic |
|---|---|---|---|---|
| Individual | $174.43 | $132.06 | $103.92 | $77.67 |
| Individual and spouse | $342.04 | $257.27 | $200.98 | $148.43 |
| Individual and children | $375.97 | $273.93 | $210.13 | $153.06 |
| Individual and family | $571.05 | $418.46 | $321.64 | $234.08 |
| Who is covered | Elite Plus | Elite | Classic Plus | Classic |
|---|---|---|---|---|
| Individual | $219.88 | $166.28 | $128.02 | $96.83 |
| Individual and spouse | $432.97 | $325.76 | $249.23 | $186.78 |
| Individual and children | $421.42 | $308.15 | $234.23 | $172.22 |
| Individual and family | $661.85 | $486.84 | $369.80 | $272.38 |
| Who is covered | Elite Plus | Elite | Classic Plus | Classic |
|---|---|---|---|---|
| Individual | $261.43 | $197.87 | $150.06 | $114.46 |
| Individual and spouse | $515.92 | $388.78 | $293.14 | $221.94 |
| Individual and children | $462.97 | $339.75 | $256.27 | $189.85 |
| Individual and family | $744.93 | $550.00 | $413.83 | $307.61 |
| Who is covered | Elite Plus | Elite | Classic Plus | Classic |
|---|---|---|---|---|
| Individual | $369.21 | $280.76 | $207.02 | $160.46 |
| Individual and spouse | $731.52 | $554.62 | $407.12 | $313.99 |
| Individual and children | $570.77 | $422.65 | $313.23 | $235.86 |
| Individual and family | $960.35 | $715.69 | $527.68 | $399.57 |
| Who is covered | Elite Plus | Elite | Classic Plus | Classic |
|---|---|---|---|---|
| Child only | $183.38 | $129.09 | $96.68 | $68.62 |
Family rates include up to four children; additional children are charged the child rate. The Specified Disease Rider is not available on child-only coverage.
Monthly premiums transcribed from the carrier's brochure, current as at October 2025 and subject to change. They exclude the Specified Disease Rider, which is priced separately from 32 combinations of deductible and calendar year maximum before age is applied — too many for a table to be useful, so it is quoted. A $7.00 monthly administration fee for the added non-insurance services is already included in the premiums shown, except on child-only coverage.
The base plan's benefits are paid to you. The Specified Disease Rider works differently: you pay the deductible to the provider, and above it the carrier pays the remainder of the claim to the provider directly.
It is a multiple of a scheduled amount rather than a flat figure, and the carrier states that the schedule for one unit is similar to what Medicare's Physician Fee Schedule pays for that surgery. Elite Plus pays three times that schedule, Classic pays one time it. What a specific operation pays is in the policy's schedule, and we will get it for you before you buy rather than after.
Not for whether a benefit is paid — the schedule pays the same amount either way. It matters for what you are charged, because a negotiated rate is lower than a list price and a fixed benefit goes further against a smaller bill. The network and the prescription discount programme are provided by other companies and are not part of the policy.
Yes. It needs a new application and it is underwritten at that point, and the pre-existing condition period runs from then. If the rider is declined the base policy carries on unaffected.
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.