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Fixed Indemnity Insurance in Oregon

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. Oregon excludes it from the definition of a health benefit plan.

At a glance

Fixed indemnity is available in Oregon as a supplemental, limited-benefit product; the Oregon Division of Financial Regulation regulates it, and it is excluded from the definition of a "health benefit plan."
It pays a fixed cash amount per covered event or day, regardless of your actual costs — it doesn't work like major medical.
Oregon applies standard supplemental treatment — no unusual per-day minimum is layered on, but a disclosure and outline of coverage are required so buyers see exactly what the plan pays.
It's not ACA minimum essential coverage and not a substitute for a comprehensive plan; most people pair it with an ACA plan. Oregon runs a State-Based Exchange on the Federal Platform (you enroll via HealthCare.gov) and has expanded Medicaid.

What Oregon allows

Oregon permits fixed indemnity insurance as a supplemental, limited-benefit product. It is an excepted benefit, excluded from the definition of a "health benefit plan" under ORS 743B.005(16)(b)(G), and the Oregon Division of Financial Regulation (DFR), part of the Department of Consumer and Business Services, oversees it. Oregon applies standard supplemental treatment (OAR ch. 836), with a disclosure and outline of coverage required so you can see exactly what the plan does and does not pay.

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.) Along the same lines, dental-only, vision-only, and accident-only coverage are also excluded from the "health benefit plan" definition under ORS 743B.005(16)(b).

The core thing to understand is how it pays: fixed indemnity pays a predetermined cash amount when a covered event happens — for example, a set amount per day in the hospital — 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 Oregon

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. Because Oregon requires a disclosure and outline of coverage, you'll have a document that spells out exactly what the plan pays — read it closely. These products are designed to supplement real coverage, not replace it. 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.

For the comprehensive coverage that fixed indemnity is meant to supplement, Oregon runs the Oregon Health Insurance Marketplace as a State-Based Exchange on the Federal Platform, so you enroll in ACA plans through HealthCare.gov (annual Open Enrollment in the fall through early winter, plus Special Enrollment Periods for qualifying life events like losing job-based coverage, moving, or having a baby). Oregon 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 Oregon 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, use the required outline of coverage to compare exactly what a plan pays — 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 Oregon law and Oregon Division of Financial Regulation guidance as of the last-reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.