With an ACA health plan, you pay a monthly premium and typically, a co-pay when you visit your doctor. When choosing your plan, it’s important to look at the deductible, which is the amount of money you pay before your insurance “kicks in,” and your out-of-pocket maximum, which is the total amount of money you pay annually before your insurance covers you 100%.

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Also, keep in mind, that while all ACA health insurance plans include dental and vision coverage for children, they may not include it for adults. If you need vision and dental coverage, and your plan doesn’t include it, you’ll have to purchase it separately. Fixed indemnity plans aren’t traditional health insurance coverage.

 

These plans are designed to supplement your health insurance by reimbursing you for out-of-pocket expenses you pay on covered medical treatments and procedures. For example, if your health insurance has a $500 deductible for emergency room visits, this is what you pay if you receive treatment at the ER. Then, you can submit your receipts to the provider who manages your fixed indemnity plan for reimbursement.

 

Keep in mind, fixed indemnity plans don’t cover pre-existing conditions. In fact, they typically have a list of specific procedures and medical treatments that are covered, so make sure you understand when you’re reimbursed and when you aren’t before you buy. Also, the amount of costs reimbursed to you could affect your Medicaid eligibility (if applicable).