Why Are Health Indemnity Plans Important?
I have a friend that I helped with a Short Term Medical plan not long ago. She did not use the plan while the plan was active. As luck would have it, on the 95th day (only five days after the plan expired). She had a bad fall and broke her index finger. She called the insurance company and per guidelines, she could not purchase another Short Term Medical plan. She could purchase one from another company, but, it would not cover the pre-existing condition (her broken finger).
She asked if I had other options for her and at that moment, I did not! After sharing my disappointment of not having an alternative for her, I asked her for a day or two find something that may work for her. What I found is, Health Indemnity Plans and there are several plans to choose from I would like to provide an overview of the benefits that they have common.
Health Indemnity Plans help families budget health care expenditures, by providing multiple fixed health insurance benefits members can choose from, according to their health care needs. These plans provide good basic hospital, medical and outpatient Limited Benefit coverage with additional wellness benefits and doctor’s office visit benefits, to promote preventive care. Since all the benefits are defined in the plan it helps to allow you the consumer to consciously choose providers of your choice and health care options.
How does a Health Indemnity plan work?
With a Health Indemnity plan, you can see the doctors or specialists of your choice, with no referral required.
Though you may choose to get the majority of your primary care from a single doctor, your insurance company will not require you to choose a primary care physician.
Some plans may require that you pay up front for services and then submit a claim to the insurance company for reimbursement.
You may be required to pay an annual deductible before the insurance company begins to pay on your claims. If so, once your deductible has been met, the insurance company will typically pay your claims at a set percentage of the (UCR) “usual, customary and reasonable rate” for the service. You would pay the difference.
What Health Indemnity Insurance Is not
It is not major medical insurance and does not provide the mandated coverage necessary to avoid a penalty under the Affordable Care Act (ACA), often called Obamacare.
It does not provide coverage for all the essential health benefits outlined in the ACA. And unlike an ACA plan, it will most likely not provide coverage for expenses resulting from any preexisting medical conditions.
I am sure we know someone under 65, without health insurance for one reason or another and in today’s market where health insurance is often unavailable or not affordable. A Health Indemnity Insurance Plan may be an affordable solution.
For more information, contact us today.