Excepted benefits are those benefits that are not subject to the traditional federal requirements under the ACA. They are separate from, and generally supplemental to, your other major medical health insurance, and are offered as independent, non-coordinated benefits. An excepted benefit fixed indemnity plan is an insurance product that pays pre-set or fixed amounts for medically necessary services regardless of what a medical provider charges and up to a certain total annual coverage amount.
Under an excepted benefit fixed indemnity plan, you are responsible for the provider’s price above the Benefit Amount your plan pays, and you enjoy the savings if the provider’s price is less than the Benefit Amount Your plan pays. The Access Plan marketed by Sidecar Health is an excepted benefit fixed indemnity plan.
To see what fixed rates are available, visit Preview Coverage. Just remember that larger or more complex procedures have multiple components that plans would pay for, so if you were looking to see what plans pay for something like a surgery, you would want to make sure to submit a pre-bill or look up the provider fee, facility fee, anesthesia, labs, imaging, prescriptions, etc. to get a full picture.