Most healthcare providers define “health insurance” in the context of traditional comprehensive major-medical health plans that pay providers (rather than covered persons) for services rendered. By contrast, the classification of fixed-indemnity policies—including the one offered by Atlas Direct—can vary substantially from one provider to another.

Here are some key points to consider:

Provider Policies on Discounts 

  • Many healthcare providers offer self-pay, cash-pay, or no-insurance discounts to patients who do not have comprehensive major-medical health insurance.  
  • These discounts are generally meant for patients who pay for their medical expenses out of pocket rather than having some or all of their medical expenses paid by a comprehensive major-medical health insurance plan.

Fixed-Indemnity Policies

  • Fixed-indemnity policies are not designed to be primary, comprehensive health insurance plans.
  • Fixed-indemnity insurance policies pay a predetermined amount directly to covered persons for covered events, irrespective of the actual cost of medical services.
  • This structure differentiates them from traditional comprehensive health insurance plans that pay healthcare providers for any costs in excess of the deductibles, copays, and coinsurance amounts that are paid to providers by the insured person.

Classification of Fixed-Indemnity Policies 

  • Some providers may not consider fixed-indemnity policies to be “health insurance” for the purposes of granting self-pay, cash-pay, or no insurance discounts, especially since the fixed-indemnity payments are made directly to covered persons rather than to providers.
  • Conversely, other providers may still consider any form of health-related coverage, including fixed-indemnity policies, as insurance and thus may not offer self-pay, cash-pay, or no-insurance discounts to patients who inform them that they have fixed-indemnity coverage.

Transparency and Communication

  • It may, in some cases, be helpful for you to communicate with your provider's billing department.
  • You may want to explain that you have fixed-indemnity coverage that pays you directly and confirms whether this qualifies you for any self-pay, cash-pay, or no-insurance discounts. 
  • Asking those sorts of questions may help you to receive appropriate discounts and avoid misunderstandings about your coverage status. On the other hand, some providers may withdraw their discounts if you inform them that you have fixed-indemnity insurance.