ACA and Indemnity Insurance: Everything You Need to Know

Are you confused about whether your indemnity insurance plan qualifies as proper healthcare coverage under the Affordable Care Act (ACA)? Don’t worry, you’re not alone. In this blog post, we’ll explore this topic in detail and provide you with the information you need to make informed decisions about your health insurance coverage.

What is Indemnity Insurance?

Indemnity insurance, often referred to as “fixed indemnity insurance,” is a type of health insurance plan that provides coverage for specific medical expenses on a predetermined basis. Instead of paying for the actual medical services you receive, indemnity plans reimburse you for certain medical bills up to a set amount.

ACA Coverage Requirements

The ACA requires all health insurance plans to provide certain essential health benefits (EHBs). These benefits include coverage for doctor visits, hospitalization, prescription drugs, mental health services, and more. Comprehensive health insurance plans, sometimes referred to as “major medical” plans, meet these EHB requirements.

Indemnity Insurance and ACA Compliance

Indemnity insurance plans do not meet the ACA’s EHB requirements and are considered non-comprehensive health coverage. This means that they do not provide the same level of protection as comprehensive health insurance plans.

ACA Subsidies and Non-Comprehensive Plans

If you have indemnity insurance and your income is within the eligibility limits, you may qualify for premium subsidies to help you purchase a comprehensive health insurance plan through the ACA Marketplace. This is because non-comprehensive plans do not constitute “minimum essential coverage” under the ACA.

Understanding Your Plan

It’s essential to carefully review your indemnity insurance plan documents to understand the coverage it provides. If you have any questions or concerns, don’t hesitate to reach out to your insurance carrier or a licensed health insurance agent.

Steps to Take If You Have Indemnity Insurance:

1. Determine if your plan meets ACA requirements.
2. If it doesn’t, explore your options for obtaining comprehensive health insurance coverage.
3. Consider applying for ACA premium subsidies to reduce the cost of your coverage.
4. Consult with a licensed health insurance agent for professional guidance and support.

Remember, understanding your health insurance coverage is crucial for ensuring you have access to the necessary medical care. If you have indemnity insurance and are unsure about its ACA compliance, seek expert advice to make informed decisions about your health insurance needs.