Get answers to common questions.
- What is medical indemnity insurance?
This type of plan gives you a fixed cash benefit payout in case you experience specific illnesses or injuries covered by your policy. For some people, one of these plans may be a helpful add-on to a regular health insurance plan to cover out-of-pocket costs for medical expenses they expect to incur during the year.Close
- Are medical indemnity medical policies the same as Obamacare?
No, medical indemnity insurance isn't the same as a regular health insurance plan, or major medical insurance. Further, these plans are not considered minimum essential coverage that conforms to the Affordable Care Act (ACA), or Obamacare. Medical indemnity plans may only cover a limited set of illnesses, injuries, drugs, and/or medical procedures, and may not cover hospital costs--so check your policy brochure carefully. What's more, these plans are not always guaranteed issue, so you may have to go through the medical underwriting process. And, keep in mind, you may still incur a tax penalty for not having an Obamacare-compliant health plan. For your particular health and financial needs, a medical indemnity plan may serve you best if you don't have a regular health, or major medical, insurance plan. So, be sure to enroll in a major medical insurance plan during the Open Enrollment Period or during a Special Enrollment Period if you qualify.Close
- Why would I need a medical indemnity plan?
The appeals of medical indemnity plans are that:Close
- Premiums are affordable.
- You know in advance what benefit amount you can expect for covered medical events.
- You don't have to pay a deductible before receiving your benefits.
- You don't have to incur medical expenses first, then wait to be reimbursed by the insurance company.
- Plan benefits can help defray any out-of-pocket medical costs.
- How do medical indemnity medical policies work?
You can enroll in these plans at any time of the year, because there's no Open Enrollment Period, then you generally pay periodic premiums for your plan. If you experience a covered medical event during your coverage period, you file a claim, and the plan pays you a predetermined benefit amount, regardless of whether your medical services actually cost more or less.Close
- When can I claim benefits from my policy?
You don't have to meet a deductible or pay upfront for your medical services, then wait to get reimbursed, as you normally would with a regular health plan, also called a major medical plan. The fixed-benefit indemnity medical policy pays you the specified benefit amount once your claim is approved. Do be aware, though, that your policy may have a per-incident, yearly, and/or lifetime benefit payout limit.Close
- Can I see any doctor I want?
This type of medical plan can be suitable if you want flexibility and freedom. For one thing, you can choose among different plans with varying benefits and premiums. Next, medical indemnity plans usually don't constrain you to a particular medical provider network or require you to get a referral to see a specialist. You can usually see any doctor or other healthcare provider you like for covered services. However, you may get a discount if you use a preferred network of medical providers.Close
- Can I afford a medical indemnity medical plan?
Again, with these policies, the insurance company gives you a set cash benefit payout for illnesses, injuries, and other medical events that are covered by your plan. Your benefit payout is fixed, regardless of the actual cost for your medical services. See the medical indemnity plans offered by eHealth Insurance, and see how affordable these plans can be.Close
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