Health Insurance
Off-marketplace coverage for healthy people under 65 — not a one-size-fits-all template
If you earn too much for a comfortable ACA subsidy, or you’re paying full price for an individual plan you barely use, you already know the problem.
Clayland Insurance helps healthy individuals and families under 65 compare a fixed benefit health plan sold outside the marketplace. Licensed in Pennsylvania, Maryland, Delaware, and Virginia.
Who This Is For
A fixed benefit health plan isn’t for everyone — but for the right person, it can be a smarter alternative to a full-price marketplace policy.
This coverage is a strong fit if you:
Under age 65
Are self-employed, 1099, or own a small business
Earn too much for comfortable ACA subsidies
Are paying full price for an individual plan
Are generally healthy and able to pass underwriting
Want more flexibility and control
If that’s you, a fixed benefit health plan is one of the options most people never hear about.
Why People Look for Off Marketplace Health Insurance
If you pay for your own coverage, you’ve probably felt it — higher premiums, fewer choices, and plans that don’t seem built for how you actually use care. That’s why many healthy families look for off marketplace health insurance instead of another year on a plan they barely touch.
The Problem with Typical ACA Plans
Rising premiums every year
Narrow provider networks
Long appointment waits
Limited flexibility
You end up paying for coverage you don’t actually use.
What the Plan Pays
What Fixed Indemnity Hospitalization Benefits Cover
An indemnity health plan pays a set amount for covered care — not a percentage after a deductible you may never meet.
Hospitalization Plan Pays Benefits For:
Hospital Confinement
A fixed dollar amount per covered hospital day — listed in writing before you enroll — instead of waiting to satisfy a large deductible.
Intensive Care Unit (ICU)
A separate fixed benefit for covered ICU days, so the most expensive days in the hospital have their own stated amount.
Outpatient Surgery
A set benefit for covered outpatient surgical procedures, paid as a fixed amount per event rather than a coinsurance percentage.
Professional Fees
Fixed benefits toward covered physician and professional charges tied to a hospital stay, surgery, or other eligible event.
Emergency Room Visits
A stated benefit for covered ER visits, so you know the amount the plan pays before you walk through the door.
Testing & Therapy
Fixed benefits for eligible diagnostic testing and therapy, with the same dollar-amount structure as the rest of the plan.
- Fixed benefit amounts listed in writing before you enroll
- No network — see any licensed doctor or hospital
- First-dollar benefits on eligible services
- You choose the benefit level
- Care anywhere in the U.S.
Many plans include first-dollar benefits — meaning coverage can begin immediately for eligible services instead of waiting to meet massive deductibles. Member tools such as telehealth, fair-price lookup, Rx savings, and bill advocacy are included with the plan; see the member tools included with your plan.
How a Fixed Benefit Health Plan Works
A fixed benefit health plan — also called an indemnity health plan or fixed benefit indemnity coverage — pays a set amount per covered event. Not a percentage of the bill after a deductible.
Every benefit amount is listed in writing before you enroll, so you know what the plan pays for a hospital day, a surgery, or a doctor visit up front. There is no network: see any licensed doctor or hospital you choose, here or anywhere in the U.S.
Benefit levels you select
Lifetime maximum protection
Hospital and outpatient coverage
No network — any licensed provider
Benefit amounts in writing before you enroll
First-dollar benefits on eligible care
Virtual care options
Preventive services
Every plan is structured around your budget, your risk tolerance, and your health profile.
Fixed indemnity plans are excepted benefits — they are not a substitute for comprehensive coverage. We explain exactly how they differ before you make any decision.
Non-ACA Health Insurance: What’s Different
These are private, medically underwritten plans sold outside the marketplace. They are not ACA plans and do not include ACA subsidies. For people who don’t benefit from those subsidies, they are one of the ACA alternatives worth understanding before you enroll again by default.
That’s why they can often:
Cost less
Offer greater flexibility
Provide faster access
But underwriting matters. This isn’t right for everyone.
An Alternative to Obamacare — Without Pretending It’s the Same Thing
People searching for an alternative to Obamacare are usually paying full price on the marketplace and getting little or no subsidy. A fixed indemnity plan can cost less and give you more say in where you get care. It is not a substitute for comprehensive major medical coverage, and it is not guaranteed-issue.
If a marketplace plan is genuinely the better fit — because of a subsidy, a health condition, or the kind of coverage you need — we will tell you that. Honesty is the filter. We would rather send you to the right option than put you in the wrong plan.
Who It’s Not For
This type of coverage works well for many people — but it’s not the right solution for everyone.
This may not be the right solution if:
You have major unmanaged pre-existing conditions
You qualify for Medicaid
You are 65 or older — Medicare is the right conversation
You require guaranteed issue coverage
You receive a meaningful ACA subsidy
You need comprehensive major medical coverage
If that’s the case, we will tell you honestly.
Our Process
Getting Started
1: Start the Conversation
Fill out our short form or call us directly. We'll schedule a quick phone call to understand your needs, goals, and current coverage.
2: Review Personalized Options
We gather the right information, design coverage options for you and your family, and meet virtually or in person to review what works best.
3: Get Covered and Supported
We handle the paperwork and finalize your customized plan—then stay available to support you before, during, and after enrollment.
A simple, guided process designed around you—not insurance companies. After you enroll, your plan includes savings and advocacy tools; here is how fixed indemnity insurance works day to day.
Why Work with Clayland Insurance?
Because choosing a fixed benefit health plan isn’t just about the policy — it’s about who’s guiding you through it. Meet Bill, read client testimonials, or contact us directly.
Some Benefits:
- Based in Littlestown, PA
- Serving Adams County, York County, and clients across Pennsylvania, Maryland, Delaware, and Virginia
- PA Licensed in Accident & Health (#1139650); also licensed in Maryland, Delaware, and Virginia
- Local support — not a call center
- Straightforward explanations
- Long-term relationship focus
When you call, you speak to Bill. If you want a local visit, start with our Adams County health insurance page. Live across the line? Private health insurance in Maryland is a separate walkthrough. Many families also add dental insurance in Pennsylvania.
Authorized & Trusted Agency Partners
Proudly working with established carriers and benefit providers to serve the families we work with
Ready to See If You Qualify?
If you're healthy, under 65, and tired of overpaying for coverage you barely use, it’s worth a conversation.
Live in Maryland? See our private health insurance in Maryland. Near Gettysburg or Littlestown? Visit health insurance in Adams County. Need teeth and eye coverage too? Compare dental insurance in Pennsylvania.
Common queries
Frequently Asked Questions
A: A fixed benefit health plan is worth it when you are healthy, under 65, able to pass medical underwriting, and you get little or no ACA subsidy. You trade a comprehensive, percentage-after-deductible design for stated dollar amounts, often a lower premium, and no network. If you have significant ongoing care needs or a meaningful subsidy, a marketplace plan is usually the better fit, and we will say so. The only way to know if fixed indemnity insurance is worth it for you is a written quote — it is free and there is no obligation.
A: No. These are private, medically underwritten plans sold outside the marketplace. They are not ACA plans and do not include ACA subsidies — they are an alternative for people who do not benefit from those subsidies in the first place. We explain the differences plainly before you decide anything.
A: Yes. Fixed benefit plans have no network, so you can see any licensed doctor or hospital — in your state or anywhere in the U.S. — without a network penalty. We still review your preferred doctors before enrollment so you know how the benefit amounts apply.
A: Anyone with major unmanaged pre-existing conditions, a meaningful ACA subsidy, Medicaid eligibility, a need for guaranteed-issue coverage, or anyone 65 or older. Medicare is the right conversation at 65, and we will point you in the right direction rather than force a fit.
A: Bill Clayland — an independent advisor based in Littlestown, PA, licensed in Pennsylvania (#1139650), Maryland, Delaware, and Virginia. You work with Bill directly, from the first call through every year you keep the plan.
A: Yes. There is no network, so covered benefits apply with any licensed provider in the U.S. We confirm the details for your plan during the consultation.
A: In many cases, coverage can begin within weeks, depending on underwriting and approval.
A: Nothing. Quotes are free and there is no obligation. And if a marketplace plan or Medicare is genuinely your best option, we will tell you that too.
Fixed indemnity insurance is an excepted benefit and is not a substitute for comprehensive (major medical) health insurance or minimum essential coverage as defined by federal law. Plans pay fixed benefit amounts for covered services regardless of the actual cost of care, are medically underwritten, and are not guaranteed issue. Benefits, availability, and eligibility vary by plan and are described in the policy documents.