Fixed Benefit Health Insurance

Fixed Benefit Health Insurance and ObamaCare

Fixed benefit health insurance, or indemnity insurance, is not ObamaCare compliant and is not the same as major medical plans sold on the marketplace. Fixed benefit plans are sold by private companies and pay a specific amount each time you see a doctor or go to a hospital. The ACA is trying to take these plans off the market as they do not meet the standards of minimum essential coverage.

Fixed benefit plans were popular in the past due to their cheap overhead, however a fixed benefit plan is a big gamble as it could leave you with major medical costs out of pocket in a worse case scenario. Still many are choosing fixed benefit plans to supplement their current plans or are holding on-top their plans due to grandfathered status obtained before the law went into place.

Are Fixed Benefit Health Insurance Plans Minimum Essential Coverage?

Fixed benefit plans are not minimum essential coverage and will not help you avoid the fee for having health insurance. Before the ACA was passed fixed benefits plans were a cheap way to get some help with healthcare costs, but due to their failing to meet many new standards and regulations they may be phased out by about 2017.

Beware brokers who try to pass off fixed benefit health plans as ObamaCare compliant plans. As a rule of thumb if a plan starts right away, is suspiciously cheap and is being sold outside of the marketplace you may be being pitched a supplemental, fixed benefit, short-term or other type of non-ObamaCare compliant plan and will still owe the per month fee for not having health insurance.

fixed benefit health insurance

Why Get Fixed Benefit Health Insurance?

Unlike supplemental or short term coverage options there really isn’t much of a reason to get a fixed benefit plan. They aren’t ACA compliant and despite their cheap cost they will cause you to owe the fee for not having health insurance. That being said it may make sense financially to keep your fixed benefit plan until 2017 if you have a grandfathered plan or in some rare cases it may make sense to buy a fixed benefit plan and pay the fee anyway.

Does Fixed Benefit Health Insurance Cost More?

Fixed benefit plans will almost always come at a low price tag, but remember they don’t have to comply with ObamaCare’s rules and regulations and you’ll still owe the fee for not having coverage unless you are keeping a grandfathered plan.

Can I get Cost Assistance on Fixed Benefit Plans?

You can only get ObamaCare’s cost assistance by enrolling in a qualifying plan on the health insurance marketplace during open enrollment. Fixed Benefit plans are not available on the marketplace and aren’t qualifying health plans.

Should I Get Fixed Benefit Health Insurance

Whether or not Fixed Benefit insurance makes sense for you depends upon your intentions and specific situation. If you have read and understand the information on this page you should have a good idea as to whether Supplemental coverage makes sense for you.


Understanding Fixed Benefit Health Insurance

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of,, and other websites. He has been in the health insurance and healthcare information field since 2012. is a...

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