He Got PAID to Go to the Doctor (This Is Legal)
What if going to the doctor actually put money back in your pocket? That's exactly what happened to Casey — and it wasn't a mistake or a loophole. It was the plan working exactly as designed.
What Happened to Casey
Casey's boss made him get a COVID test. He went to a local urgent care clinic and simply handed them his insurance card and paid nothing.
About two weeks later he recieved two checks from his insurance company totaling about $200.
The insurance company had already paid 100% of the clinic's PPO price. The excess amount was money that Casey got to keep.
He literally made money on a doctor visit. And it was completely legal.
How Indemnity Plans Work
Traditional health insurance — think the big names like Blue Cross, United, or Aetna — charges high premiums and still hits you with deductibles and copays. You pay a lot before you ever see a benefit.
Indemnity plans work differently. Here's the basic idea:
The plan pays a set dollar amount for covered services.
There are no deductibles and no copays for all outpatient benefits.
If the cost is less than the benefit amount, you keep the difference.
That last point is the key. Casey's COVID test cost less than his plan's benefit for that service. So he walked away with more money than he spent.
Why This Rewards Smart Shopping
Traditional insurance removes any reason to shop around. You pay your premium, hit your deductible, and the insurance company starts paying some after that. You never see the actual prices, and you have no reason to care.
Indemnity plans flip that completely. When you keep the savings, you want to find the best price. Cash-pay prices at clinics, imaging centers, and labs are often 50–80% lower than what traditional insurance networks charge.
That's not a coincidence. When patients shop and negotiate, providers compete. Real competition drives real prices down for everyone.
How Small Businesses Can Offer This
Small business owners can offer an employer-sponsored indemnity plan through The Benefit X-Change. Here's how it works alongside an ICHRA:
The employer sets a defined-contribution amount with no minimum and no maximum. Employers can even set different benefit amounts for different classes of employees.
Employees who opt out of the ICHRA can use that same contribution amount toward their indemnity plan instead. If the indemnity premium is less than the defined-contribution, the employee pays nothing out of pocket. If it's more, the difference comes out of their paycheck.
It's a flexible, affordable way to give employees real health coverage without the crushing cost of traditional group insurance.
The Bottom Line
Casey's story isn't unusual. It's what happens when employees have a reason to be smart healthcare consumers. An indemnity plan gives them that reason and rewards them for it.
If you're a small business owner looking for a better way to offer health benefits in 2026, this is worth a serious look.
Visit benefitx.com to learn more about ICHRA administration and employer-sponsored indemnity plans for your team.
