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Fixed Indemnity Insurance in Colorado

Fixed indemnity pays a set cash amount per covered event or hospital day regardless of the bill, a supplement to health insurance rather than a replacement for it. Colorado's 2025 rule requires a page-one consumer notice and bars marketing it as an ACA substitute.

At a glance

Fixed indemnity is available in Colorado but restricted under a new 2025 rule; it is a supplemental, limited-benefit product with added disclosure and structuring requirements.
Colorado Regulation 4-2-40 (amended effective October 1, 2025) requires a page-1 consumer notice, a separate policy, no coordination of benefits, and bars marketing fixed indemnity as an ACA substitute (4-2-40-12).
It pays a fixed cash amount per covered event or day, regardless of your actual costs — it doesn't work like major medical.
It's not ACA minimum essential coverage and not a substitute for a comprehensive plan. Colorado runs its own state exchange, Connect for Health Colorado, and has expanded Medicaid.

What Colorado requires

Colorado permits fixed indemnity as a supplemental, limited-benefit product, but it is allowed only on a restricted basis under a new 2025 rule. Colorado Regulation 4-2-40, amended effective October 1, 2025, imposes several requirements (4-2-40-12):

A mandatory page-1 consumer notice stating that the policy "may pay you a limited dollar amount" — placed on the first page so you see it up front.
It must be sold as a separate policy, not bundled into comprehensive coverage.
No coordination of benefits with other coverage.
It may not be marketed as an ACA substitute — that is, it cannot be presented as a stand-in for major medical or minimum essential coverage.

Under this regime, accident, specified-disease/critical-illness, and hospital-indemnity products all fall under the same Reg 4-2-40 disclosure and anti-substitution requirements (effective October 1, 2025).

Because fixed indemnity is an excepted benefit, it sits outside ACA rules. At the federal level, a 2024 fixed-indemnity consumer-notice requirement was vacated by a court in December 2024, so it is not federally required; an earlier 2014 individual-market notice still applies. Colorado's page-1 notice requirement is a separate, state-level rule under Reg 4-2-40.

The core thing to understand is how it pays: fixed indemnity pays a predetermined cash amount when a covered event happens — no matter what your treatment actually costs. That's very different from major medical, which pays a share of your actual bills.

How fixed indemnity works in Colorado

Fixed indemnity and related excepted benefits come in a few forms (described as coverage types, not specific products):

Hospital indemnity — pays a fixed amount per hospital stay or per day admitted.
Accident coverage — pays fixed amounts for specified injuries or accident-related care.
Specified-disease or critical-illness coverage — pays a fixed benefit if you're diagnosed with a covered condition.

Each pays a fixed cash benefit you can use toward bills, deductibles, or everyday costs during a covered event. In Colorado, all of these products carry the Reg 4-2-40 page-1 notice, must be a separate policy, and can't coordinate benefits or be marketed as an ACA substitute — so read the first-page notice and the policy closely. As an independent, carrier-neutral brokerage, we don't push any single insurer — and we'll be clear that fixed indemnity works best alongside a comprehensive plan, not instead of one.

How to get coverage here

Fixed indemnity isn't sold through the health insurance marketplace, and it isn't tied to Open Enrollment — you can generally apply for it year-round, directly from an insurer or through a broker, subject to the product's terms and Colorado's requirements.

For the comprehensive coverage that fixed indemnity is meant to supplement, Colorado runs its own state-based exchange, Connect for Health Colorado, where ACA plans have an annual Open Enrollment (typically each fall through early winter) and Special Enrollment Periods for qualifying life events like losing job-based coverage, moving, or having a baby. Colorado has expanded Medicaid, so it's worth checking your eligibility there as well.

What it costs

We don't quote premiums here — prices depend on your situation — but the cost of fixed indemnity in Colorado is driven by:

The benefit amounts you choose — higher fixed payouts (for example, a larger per-day hospital benefit) cost more.
The type of product — hospital indemnity, accident, or specified-disease coverage.
Your age — older applicants generally pay more.
Who's covered — an individual or a family.
Any riders or add-ons you select.

Because fixed indemnity pays fixed amounts rather than a share of your bills, the real question is how much cash it pays for the events you're most concerned about — and remember it's supplemental, so weigh it alongside the cost of the comprehensive coverage it's meant to support.

MG Matthew T. Giberti Licensed Expert · NPN 20698856 · Updated July 2026

Fixed indemnity insurance is a supplemental, limited-benefit (excepted-benefit) product. It pays fixed cash amounts for covered events regardless of your actual medical costs, is not major medical coverage, and is not minimum essential coverage under the Affordable Care Act. It does not cover the full range of essential health benefits and is not a substitute for a comprehensive health plan.

GetHealthPlans.com is operated by MTG Insurance Agency, an independent, carrier-neutral brokerage. We do not issue insurance and are not a government agency or the health insurance marketplace. Regulatory details on this page reflect Colorado law and Colorado Division of Insurance guidance as of the last-reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.