Fixed Indemnity Health Insurance in Texas. What It Pays and Who It Suits.
Fixed indemnity health insurance pays you a set cash amount for covered care, no matter what the provider bills. We compare plans from top carriers, explain exactly what each one pays, and show where it fits alongside your existing coverage.
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This Is a Good Fit If You Are
Carrying a High Deductible
Your major medical plan has a deductible you could not comfortably cover tomorrow. Additionally, you want cash in hand if a hospital stay happens.
Between Major Medical Plans
You missed open enrollment or you are waiting on a start date. Fixed benefit coverage has no enrollment window to wait for.
Self-Employed in Texas
You buy your own coverage and every premium dollar is yours. A supplemental plan softens the worst-case year without a richer major medical plan.
Turned Down or Priced Out
Major medical is not an option right now. This pays a stated benefit for covered events regardless of what the hospital charges.
Wanting Nationwide Doctor Choice
You do not want a referral or a gatekeeper. Any doctor in the country is available, with extra savings inside the network.
Supporting a Small Business Team
You want to offer something meaningful without the cost of a full group major medical plan for every employee.
Top Carriers We Work With
What Fixed Indemnity Health Insurance Actually Pays
A fixed indemnity health insurance plan pays a stated dollar amount for a covered event, regardless of the actual bill. If the plan pays $2,000 a day for a hospital stay, that is what arrives, whether the hospital charges $1,400 or $14,000.
What the benefit schedule covers:
1️⃣ Hospital confinement
A set amount for each day you are admitted, paid on an unlimited number of confinements.
2️⃣ Surgery and anaesthesia
A stated benefit per procedure, including outpatient surgery, set out in the plan schedule.
3️⃣ Doctor and specialist visits
A fixed amount per visit, with no referral needed and no primary care physician to go through.
4️⃣ Diagnostic tests and imaging
Lab work and imaging are paid at the stated benefit for the plan you choose.
5️⃣ Preventive care from day one
Physicals, screenings and immunizations are covered immediately, with no waiting period.
See What You Would Actually Pay
Fixed Indemnity Health Insurance vs Major Medical
Major medical pays a share of your actual costs after a deductible and caps your worst year with an out-of-pocket maximum. Fixed indemnity health insurance pays a set amount per covered event and carries no such cap, so the two work together rather than against each other.
Where the two differ:
1️⃣ How the money is calculated
Major medical pays a share of the real bill. A fixed benefit plan pays a stated amount per covered event.
2️⃣ Who receives the payment
Major medical mostly pays the provider. The fixed benefit is paid to you, so you decide where it goes.
3️⃣ Whether your costs are capped
Major medical has an out-of-pocket maximum. A fixed benefit plan does not, which is why it supplements rather than replaces.
4️⃣ When you can enroll
Major medical needs open enrollment or a qualifying event. A fixed benefit plan can start in any month.
5️⃣ How long you can hold it
Major medical renews annually. This plan is guaranteed renewable to age 65.
Where a Fixed Benefit Plan Fits Alongside Your Coverage
Most people who buy one already have major medical and are using the fixed benefit plan to cover the gap their deductible leaves. A $7,000 deductible is only protection if you can actually produce $7,000.
The gaps it is bought to close:
1️⃣ The deductible you cannot absorb
Rising deductibles are the reason this product has grown. The cash arrives while the bills do.
2️⃣ The income you lose while recovering
The benefit is yours, so it can cover rent or lost wages rather than only medical bills.
3️⃣ The months between plans
There is no open enrollment period, so coverage can start in any month of the year.
4️⃣ The 90 day wall on short term plans
Unlike short term coverage, there is no 90 day limit on how long you can hold this.
Pre-Existing Conditions, Waiting Periods and Renewal
Preventive care starts immediately at the benefit amount you selected, but a condition you already have works differently, which makes this a plan to put in place before you need it.
What to know before you apply:
1️⃣ Preventive care has no waiting period
Routine physicals, diagnostic tests, Pap smears, mammograms, immunizations and cancer screenings are covered from day one.
2️⃣ Pre-existing conditions after 12 months
Benefits for a condition you already had become payable once you have held the policy for 12 consecutive months.
3️⃣ Guaranteed renewable to age 65
You cannot be singled out for a rate increase or a cancellation because your own health changed.
How the Cash Benefit Actually Gets Used
The payment goes to you rather than to the hospital, which is the part people find surprising and the part that makes the product useful.
What Texans put the benefit toward:
1️⃣ The major medical deductible
The most common use, and the reason most people buy the plan in the first place.
2️⃣ Coinsurance and copays
The share of the bill your main plan leaves with you after the deductible is met.
3️⃣ Everyday bills during recovery
Rent, childcare and groceries do not pause because you are in hospital.
4️⃣ Costs your main plan excludes
Travel to a specialist, time off work, and the smaller expenses nobody budgets for.
Why Texans Choose Custom Health Plans
What the UnitedHealthOne Health ProtectorGuard Plans Include
MultiPlan Nationwide PPO Network
Choose any doctor or provider in the United States. Extra savings apply inside the MultiPlan national network, but network providers are not required to receive benefits.
Deductible Choices From $0 to $5,000
A higher deductible lowers the premium in exchange for a reduction in benefits paid. You pick the trade you are comfortable with.
Benefits From Day One
Preventive care is covered with no waiting period, including routine physicals, diagnostic tests, Pap smears, mammograms, immunizations and cancer screenings.
No Coordination of Benefits
The plan does not coordinate with your other health insurance, so there is no waiting on another insurer before your benefit is paid.
Historically No Rate Increases
Since the product launched there have been no premium increases on in-force business.
Unlimited Hospital Confinements
Every Health ProtectorGuard plan covers an unlimited number of hospital confinements.
Pre-Existing Conditions After 12 Months
Covered benefits for pre-existing conditions become payable once you have held the policy for 12 consecutive months.
No Lifetime Benefit Maximum
Overall cash benefits are not capped for as long as the plan stays in effect.
Guaranteed Renewable to Age 65
You cannot be singled out for a rate increase or a cancellation based on a change in your health alone.
How to Get Fixed Indemnity Health Insurance (3 Simple Steps)
1. Tell Us About You
Your age, county, current coverage and the deductible you are trying to cover. One short call or the form on this page.
2. Compare the Benefit Schedules
We put the plans side by side and show what each one actually pays per day, per surgery and per visit, in plain numbers.
3. Enroll With Help
We handle the application, confirm the effective date, and stay on as your broker for renewals and claim questions.
Good Fit vs Not a Fit (Save Time)
This is usually a good fit if:
- You already have major medical and want help with the deductible
- You want coverage that starts outside open enrollment
- You want cash paid to you rather than to the hospital
- You want any doctor in the country without a referral
- You are healthy today and planning ahead rather than reacting
This may NOT be a good fit if:
- You need this to replace major medical, because it does not cap your costs
- You have a condition needing treatment inside the next 12 months
- You are over 65, since the policy is renewable only to that age
- You want a plan that pays providers directly on your behalf
Service Areas
We are based in Plano and write fixed indemnity health insurance across Texas, including Dallas, Fort Worth, Houston, Austin, San Antonio, Frisco, McKinney and El Paso.
Check Eligibility and Get Your Options
A 5-minute conversation tells you exactly which plans fit your budget and your doctors. No pressure, no fees, no obligation.
Frequently Asked Questions
What is fixed indemnity health insurance?
Fixed indemnity health insurance is supplemental coverage that pays you a set cash amount for a covered event, such as a hospital stay or a surgery, regardless of what the provider actually charges.
The payment goes to you rather than to the hospital, so you decide what it covers. Many people use it to absorb the deductible on their major medical plan.
Is fixed indemnity health insurance the same as major medical?
No. Major medical pays a share of your real costs and caps your spending with an out-of-pocket maximum. A fixed benefit plan pays a stated amount per covered event and has no such cap.
They work best together rather than as alternatives to each other.
Can I buy a fixed benefit plan at any time of year?
Yes. There is no open enrollment period for this type of coverage, so you can apply in any month.
That is one of the main reasons Texans look at it after missing an enrollment window.
Are pre-existing conditions covered?
Preventive care is covered from day one. Benefits for a pre-existing condition become payable after you have been covered by the policy for 12 consecutive months.
Do I have to use a network doctor?
No. You can choose any doctor or provider in the United States, and you can refer yourself to a specialist without a primary care physician.
Using a provider inside the MultiPlan national network gives you additional savings, but network use is not required to receive benefits.
How long can I keep the plan?
The policy is guaranteed renewable until age 65, and you cannot be singled out for a rate increase or cancellation because your health changed.
Unlike short term coverage, there is no 90 day limit on how long you can hold it.
How much does fixed indemnity health insurance cost in Texas?
It depends on your age, the benefit amounts you choose and the deductible you select, which ranges from $0 to $5,000. A higher deductible lowers your premium in exchange for reduced benefits.
We will price the options against your budget before you commit to anything.