Advantages of hospital and doctor insurance for families

Indemnity insurance can provide additional support for your family if you or someone you love needs medical care.

It’s possible that you or a family member, such as your spouse or child, could get sick, injured or need immediate medical attention. Even if you have a traditional health insurance plan, you’ll likely have out-of-pocket expenses. And those can add up quickly, and could put a strain on your household budget.

That’s where a type of supplemental insurance called hospital and doctor insurance comes into play. (Supplemental insurance is a type of additional insurance that you pay extra for each month, on top of your traditional health insurance plan. It does not take the place of your traditional plan.) You may also see it referred to as “fixed indemnity” or “fixed benefit insurance,” and it offers a way to ease financial risk.

Below, learn more about fixed benefit insurance, how it can help your family in its time of need, and whether it might be right for you.

Want to get the full scoop on fixed benefit insurance? Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.

What is fixed benefit insurance?

Fixed benefit insurance pays a preset, or “fixed,” cash benefit for qualified medical expenses specified in the plan, regardless of other insurance coverage. (Though it’s worth noting again that it doesn’t take the place of your traditional health insurance.) These qualified medical expenses include services such as:

• Diagnostic tests
• Doctor visits
• Hospitalizations
• Prescription drugs
• Surgeries

For example, if your child has flu symptoms and you take them to the doctor, the doctor may order a flu test. A fixed benefit insurance plan could pay you a set amount of money for the doctor visit and a second payment for the diagnostic test.

How can fixed benefit insurance help me manage my family’s medical expenses?

Even with health insurance, you will have out-of-pocket costs — which can add up, especially if you have multiple family members on your plan. These costs could include:

• Your premium, or the amount you pay each month to have health insurance
• Your deductible, or the amount you pay for covered health services before your benefits kick in (there’s often an individual deductible and a higher family deductible)
• Copayments (copays), or set amounts you pay per covered health service, such as $25 for a doctor visit
• Coinsurance, or a percentage you pay for a covered service, such as 20% of an emergency room visit charge

Fixed insurance benefits pay cash whenever your family has a qualified medical expense. That’s regardless of whether you have other insurance or what your out-of-pocket expenses may be. There’s no deductible to meet before payments start. The plan will spell out the preset amounts of the benefits. This can help with managing your family’s medical expenses.

For example, if your child sprains an ankle and the doctor orders a certain number of physical therapy (PT) sessions, knowing what the plan will pay for each PT session allows you to better plan your budget.

But it’s worth knowing that fixed benefit insurance typically doesn’t cover preexisting conditions. It may also have waiting periods and limits for preventive health care services, such as annual exams.

Can my family have medical insurance and fixed benefit insurance?

Fixed benefit insurance supplements your traditional health insurance plan. It doesn’t replace it. Your health insurance will process your family members’ claims and cover costs as specified by the plan, subject to limitations, such as you meeting a deductible. Your family’s health insurance plan’s terms will determine what, if any, out-of-pocket costs you may be responsible for.

Fixed benefit insurance works separately and independently from your traditional health insurance plan. When an enrolled family member has a qualified medical expense specified in the plan, it pays a preset cash amount unrelated to what your health insurance may reimburse you for.

For example, your health insurance may require you to pay a $20 copay for a doctor’s visit. In parallel, your fixed benefit insurance may pay you $25 for a doctor’s visit. In that case, $20 would go to the doctor’s office for the copay, and you could use the remaining $5 for other expenses.

In fact, while you may want to use the cash benefit from a fixed benefit insurance plan for out-of-pocket medical costs, you don’t have to. You can use the payments in whatever way works best for your family. That could include nonmedical expenses, such as:

• Childcare
• Groceries
• Rent or mortgage payments

This flexibility is one of many benefits of fixed benefit insurance.

Thinking about a fixed benefit insurance plan? Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.

What health care providers can my family use when I have fixed benefit insurance?

You can choose any health care provider when you have fixed benefit insurance. The benefits are paid according to the qualified medical expenses specified in your plan, not based on who the provider is. Unlike some health insurance plans, you’re not required to use providers that belong to a certain network.

But you’ll want to keep in mind that your family may have lower overall medical expenses if you take advantage of the in-network savings that your health insurance company offers. Additionally, a fixed benefit insurance plan may give you access to discounts provided by in-network providers.

Is a fixed benefit insurance plan right for my family?

When shopping for fixed benefit insurance, you’ll want to consider the monthly bill for you and your family members. Can you afford to pay it every month for the entire year? Fixed benefit insurance premiums tend to be affordable — and if it fits your family’s budget, it might be worth the money.

Also, it’s worthwhile to compare the benefits that a plan will pay for qualified medical expenses, especially more common ones such as doctor visits. Those could be important, depending on the medical issues you or your family members might face.

As with any type of insurance, it’s important to read the fine print, especially the limitations, such as annual caps on benefits. What those limitations are may vary from plan to plan.

For example, one plan may pay a set amount per day a person is in the hospital, while another might pay an additional benefit if you’re in an intensive care unit or critical care unit. One plan might also pay a set amount for a surgery, while another might pay benefits based on how complex the surgery is.

In the end, you’ll want to pick a plan that works best for your family budget and needs.

A fixed benefit insurance plan could help your family during a medical emergency. Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.

Disclaimer:
For informational purposes only. This information is compiled by HealthMarkets Insurance Agency and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.