Health ProtectorGuard pays set dollar benefits for covered services. David can help you review whether it belongs next to ACA, short-term medical, employer coverage, or another plan structure.
These pages should make the tradeoff clear. Health ProtectorGuard is fixed-indemnity insurance: it pays scheduled benefits for covered services. It does not replace ACA major medical, Medicare, Medicaid, or employer coverage.
Unlike major medical insurance, Health ProtectorGuard pays scheduled dollar amounts for covered services. The plan benefit may be less than, equal to, or greater than the provider charge after network discounts and any other coverage.
Use any provider, but network pricing can matter. A UnitedHealthcare Choice Plus network provider may reduce the billed charge before fixed benefits are applied.
Your plan pays the scheduled benefit for covered services, subject to policy terms, exclusions, benefit limits, and pre-existing condition rules.
If the benefit exceeds the remaining charge, the difference may be paid to you depending on claim assignment. If the charge is higher, you may still owe a balance.
Health ProtectorGuard is filed in Florida as two distinct product families. Match the series to how you plan to use it — standalone supplemental coverage, or a paired companion to Short Term Medical.
Both families are underwritten by Golden Rule Insurance Company (a UnitedHealthcare company) on Florida policy form HPG3-GRI-09. Issue ages 18–64, renewable to age 65. These are fixed-indemnity plans — not minimum essential coverage under the ACA.
The Core series is the comprehensive Health ProtectorGuard lineup: higher daily hospital confinement benefits, Rx on every tier, and outpatient imaging included. Fixed-indemnity benefits paid per covered service. Year-1 limits shown; most benefits increase in Year 2 on renewal.
Benefits shown are Year 1 amounts per covered person. Most benefits increase in Year 2 on continuous renewal. Lifetime maximum $5,000,000 per covered person. Surgical benefits are paid based on a 7-tier schedule (max 2 surgical days per calendar year). Fixed indemnity insurance — NOT minimum essential coverage under the ACA. See policy form HPG3-GRI-09 for complete terms, limitations, and exclusions.
The Guard series is the lower-premium Health ProtectorGuard lineup, commonly paired with Short Term Medical to build catastrophic-style coverage. Guard 4000 excludes Rx and outpatient imaging; Guard 5000 and 6000 add both.
You can see any provider -- but using the Choice Plus network means pre-negotiated rates that dramatically cut your out-of-pocket costs.
*When network discount + plan benefit exceeds the billed amount, the difference is paid to you. Samples based on actual claims; amounts rounded. Actual costs and discounts vary by area and provider.
Access one of the largest provider networks in the country, with 7,000+ hospitals nationwide.
Pre-negotiated rates mean you're not paying the full sticker price. Combined with your fixed benefit, your final bill drops dramatically.
In-network providers file claims on your behalf. Show your ID card and they handle the rest. No paperwork on your end.
If the plan benefit exceeds the discounted cost, you get the difference mailed as a check. That's real money back for routine visits.
Benefits are based on the procedure's relative value unit (RVU) as established by CMS. The more complex the surgery, the higher the payout. Max 2 surgical benefit days per calendar year. Core and Guard series use the same 7-tier framework — Core benefits are higher.
| Tier | Select 2000 | Preferred 4000 | Premier 5000 | Guard 4000 | Guard 5000 | Guard 6000 |
|---|---|---|---|---|---|---|
| Tier 1 — TransplantsHeart, liver, lung, kidney (once per organ/lifetime) | $25,000 | $37,500 | $50,000 | $12,500 | $12,500 | $25,000 |
| Tier 2 — MajorIntracranial vessel surgery, esophagus removal | $10,000 | $15,000 | $20,000 | $5,000 | $5,000 | $10,000 |
| Tier 3 — ComplexEndoscopy, partial pancreas removal, valve replacement | $5,000 | $7,500 | $10,000 | $2,500 | $2,500 | $5,000 |
| Tier 4 — SignificantSpinal fusion, colectomy, valve repair | $2,500 | $3,750 | $5,000 | $1,250 | $1,250 | $2,500 |
| Tier 5 — StandardTotal knee/hip replacement, lower back disk surgery | $1,250 | $1,875 | $2,500 | $625 | $625 | $1,250 |
| Tier 6 — CommonAppendectomy, knee/shoulder reconstruction, carpal tunnel | $500 | $750 | $1,000 | $250 | $250 | $500 |
| Tier 7 — MinorTonsillectomy, breast biopsy, ear tubes | $250 | $375 | $500 | $125 | $125 | $250 |
| + Anesthesiologist | 30% of surgical | 30% of surgical | 30% of surgical | 30% of surgical | 30% of surgical | 30% of surgical |
| + Assistant Surgeon | 20% of surgical | 20% of surgical | 20% of surgical | 20% of surgical | 20% of surgical | 20% of surgical |
Every Guard Plan comes with these built-in perks -- no extra cost, no extra hassle.
Unlimited telehealth visits through HealthiestYou by Teladoc Health. Phone or video, 24/7/365. Diagnosis, treatment, and prescriptions when needed -- at zero cost to you.
Included -- All PlansSave 30-80% on prescription drugs at pharmacies near you with the Optum Perks discount card. Compare prices online and show the card at checkout. Available to everyone.
Discount Program -- Not InsuranceStick with your plan and get rewarded. After your first year, office visit maximums jump from 4 to 6, Rx fills increase from 10 to 15, and hospital confinement benefits double.
Automatic -- Year 2+The questions buyers ask most often about fit, limits, underwriting, and how this coverage differs from major medical insurance.
David can review the Core series and Guard series options that are available for your situation, then explain how the benefits, limits, underwriting, and cost compare before you apply.
No. Health ProtectorGuard is fixed-indemnity supplemental insurance. It is NOT minimum essential coverage (MEC) and does not satisfy the Affordable Care Act's individual coverage requirement. It pays fixed dollar amounts per covered service and has benefit limits. It is designed to supplement other major medical coverage or help with out-of-pocket costs — not replace it.
The Core series (Select 2000, Preferred 4000, Premier 5000) is a comprehensive fixed-indemnity product with higher daily hospital confinement benefits, Rx coverage on every tier, outpatient imaging, and a $2M calendar-year maximum. The Guard series (Guard 4000, Guard 5000, Guard 6000) is a lower-premium product often paired with Short Term Medical for catastrophic protection — Guard 4000 does not include Rx or imaging benefits, while Guard 5000 and 6000 do.
Yes. Golden Rule applies a 12-month pre-existing condition lookback and exclusion period. Conditions for which a person received medical advice, diagnosis, care, or treatment within 12 months prior to the policy effective date are generally not covered during the first 12 months of coverage. Review the certificate and Florida policy form HPG3-GRI-09 for exact terms.
Plans are underwritten by Golden Rule Insurance Company, a UnitedHealthcare company. Network access is provided through UnitedHealthcare Choice Plus, with 1.8 million providers and 7,000+ hospitals nationally — averaging 58% savings off billed charges in-network.
Issue ages are generally 18 through 64 at time of application. Coverage is renewable until age 65, subject to premium payment and policy provisions.
Get a personalized Guard Plan quote in minutes. No obligation, no pressure -- just the numbers you need to make a smart decision.
THIS PRODUCT PROVIDES LIMITED BENEFITS. This fixed indemnity insurance product pays a stated benefit amount regardless of actual expenses incurred. It is a supplement to health insurance and is NOT a substitute for the Minimum Essential Coverage required by the Affordable Care Act (ACA). This plan should not be used as a substitute for comprehensive health insurance coverage.
Plans underwritten by Golden Rule Insurance Company, a UnitedHealthcare company. Insurance plans are subject to health underwriting. Benefit availability, amounts, periods, and limitations may vary by state. Benefits are subject to preexisting condition limitations -- see policy for details. Preexisting condition limitation does not apply longer than 12 months after the covered person's effective date. Premium rates are guaranteed for 12 months, then subject to change with at least 45 days' notice (Florida). This is an outline only and is not intended to serve as a legal interpretation of benefits. Complete terms determined by the policy.
Florida policy form HPG3-GRI-09. Issue ages are generally 18 through 64, with renewal available until age 65 subject to policy provisions and premium payment. Florida requires at least 45 days' written notice before a premium change. Eligible dependent rules, hospital admission rules, benefit availability, and pre-existing condition limitations are controlled by the issued policy.
The policy may limit or exclude benefits for losses related to: preexisting conditions (12-month lookback), war, self-inflicted injury, riot, felony, armed forces service, intoxication, cosmetic treatment, pregnancy/childbirth (except complications), rehabilitation/custodial confinement, paid participation in certain sports/activities, non-commercial aircraft, services by family members, non-medically necessary services, incarceration, mental disorders/substance abuse, dental/vision, services outside the U.S. (except emergency), and experimental treatments. This is a summary -- see your policy for complete exclusion details.