Limited Benefits
Coverage When You Need It Most
Fixed Indemnity Medical Plans provide simple, predictable benefits by paying a flat dollar amount for covered services—without requiring members to meet an annual deductible. When an unexpected sickness or injury occurs, these plans offer financial support at the moment it's needed most.
There are no pre‑existing condition limitations, and plan designs and availability may vary by state.
Fixed Indemnity Medical Plans
Most plans include (but are not limited to) coverage for:
Outpatient Benefits
- Physician office visits
- Diagnostic lab services
- Diagnostic X-rays
- Ambulance services
- Emergency room care
- Outpatient surgery
- Anesthesiology
- Prescription Drugs
Inpatient Benefits
- Standard inpatient care
- Intensive care unit (ICU) services
- Inpatient surgery
- Anesthesiology
- Skilled nursing facility care
Fixed indemnity medical benefit plans are intended to provide supplemental coverage and do not replace comprehensive health insurance. These plans do not meet the requirements for Essential Health Benefits under the Affordable Care Act (ACA) and do not qualify as Minimum Essential Coverage (MEC) as defined by the Internal Revenue Code. If you do not maintain other qualifying health coverage, you may be subject to a tax penalty. Please consult your legal tax advisor for guidance.
A Practical Solution for Part-Time and Hourly Employees
These plans pay set dollar amounts for covered services with no deductibles, giving employees immediate access to care and predictable out‑of‑pocket costs.
PAI’s plans include wellness and prescription benefits, along with coverage for essential outpatient and inpatient services—such as office visits, labs, X‑rays, ER care, surgery, and hospital stays—with no pre‑existing condition exclusions.
For employers, it’s an affordable way to strengthen compensation packages, attract and retain employees, and reduce turnover. PAI manages all administration, making the experience smooth and low‑effort.
Supplemental Protection Products
These plans provide cash benefits that can be used however members need—helping reduce out‑of‑pocket costs, ease financial stress, and support recovery.
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Critical Illness Insurance: Critical illness insurance helps lessen the financial burden of serious, life‑threatening conditions. After a covered diagnosis, the plan pays a lump‑sum benefit that employees can use for anything—from medical expenses, deductibles, and child care to everyday living costs—providing vital support during a challenging time.
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Accident Insurance: Accident insurance provides a fixed benefit when an employee or covered family member is injured in an accident. These funds can help pay for copays, deductibles, coinsurance, home health care, lost wages, or any other expenses the employee chooses, making recovery more manageable.
- Dental Insurance: Flexible coverage with the freedom to choose any dentist and benefits up to 100% of allowable charges, subject to annual maximums.
- Group Term Life & AD&D: Guaranteed‑issue life insurance up to $20,000, with optional accidental death and dismemberment coverage.
- Short‑Term Disability Insurance: Income protection offered with no evidence of insurability and an issue‑age rate freeze.
- Vision Insurance: Customizable plans offering exam‑only or full coverage options, with adjustable copays, frequencies, and eyewear allowances.