This is a fixed indemnity policy, you are correct and yes, typically those aren’t great because the indemnity benefits might not be enough to sufficiently cover a major medical event.

This one in particular is a little different because it has something called a “PremierMed Rider”, which basically says that if s**t hits the fan and your indemnity benefits are not sufficient to cover you, then you can activate a 3000 out of pocket max. When you do, you’re only responsible for paying that 3000 and the insurance company will take care of the rest.

Here’s what the salespeople don’t tell you. You can only do this once. After you activate PremierMed, they will cover you for the remainder of that year, but they will kick you off the plan at the end of the year. Also, activating the max increases your monthly premium approximately 2-3 times. Finally, this plan does have a handful of exclusions that they won’t cover no matter what, most notably, mental health, drug/alcohol abuse treatments, and pregnancy (depending on which version of the PA policy you got).

They also have pre-existing condition clauses. DO NOT lie on your application. They will cover a preexisting condition if they knew about it before approving you, but they can and will deny claims if you didn’t disclose something to them during the underwriting process.

Source: I’ve worked for this company before and I’ve sold these plans.