Fixed Indemnity Insurance in West Virginia

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. West Virginia regulates it as a supplemental, limited benefit product.

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Matthew T. Giberti Matthew T. Giberti Published July 2026 3 min read
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At a glance

Fixed indemnity is available in West Virginia as a supplemental, limited benefit product; the West Virginia Offices of the Insurance Commissioner regulate it among alternatives to comprehensive coverage.
It pays a fixed cash amount per covered event or day, regardless of your actual costs, it doesn't work like major medical.
West Virginia applies standard excepted benefit treatment, no unusual state restriction or special per day minimum is layered on these products.
It's not ACA minimum essential coverage and not a substitute for a comprehensive plan; most people pair it with an ACA plan. West Virginia uses HealthCare.gov and has expanded Medicaid.
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What West Virginia allows

West Virginia permits fixed indemnity insurance as a supplemental, limited benefit product, and the West Virginia Offices of the Insurance Commissioner (WV OIC) oversee these products among alternatives to comprehensive coverage. West Virginia applies standard excepted benefit treatment, there is no unusual West Virginia restriction or special per day minimum layered on these products.

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.)

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 West Virginia

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. 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.

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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, West Virginia uses the federally facilitated marketplace at HealthCare.gov, 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. West Virginia 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 West Virginia 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.

Matthew T. Giberti Matthew T. Giberti Licensed Insurance Producer · National Producer Number: 20698856 Licensed Insurance Producer · National Producer Number: 20698856 About Matthew →

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 West Virginia law and West Virginia Offices of the Insurance Commissioner guidance as of the last reviewed date and can change; confirm current terms and the specific product's approved form before you enroll.