Accident insurance plans are supplemental health insurance plans that pay cash to you if you are injured in an accident. Benefits vary according to the severity of the injury. The more severe the injury, the higher the benefit.
If you get injured in an accident, it’s not free to get treated. Even with medical insurance, you’ll likely still have out-of-pocket medical costs that insurance doesn’t pay for like copays, deductibles and coinsurance.
That’s where accident insurance can help.
Benefits are for injuries from accidents only
Accident plans only pay benefits for injuries No benefits will be paid for treatment due to a medical condition.
Off-the-job only or 24 hour coverage?
When reviewing an accident policy, one of the first things you want to check is what type of coverage is offered.
There are two types of accident coverage available, 24 hour coverage and off-the-job only coverage.
Here is how this coverage differs:
- 24 hour coverage 24 hour coverage is around the clock coverage. Benefits are still payable if you get hurt on the job.
- Off-the-job only coverage Off-the-job only coverage doesn’t pay benefits for any injury that happens while you are at work.
Ideally, you’d want 24 hour coverage. That is what I recommend most employers offer.
However, because injuries that occur at work are workman’s comp claims, many employers do not offer the 24 hour coverage option.
Schedule of Accident Benefits Offered
Most accident plans have similar plan benefits.
Typically, benefits will be broken down into 7 different categories of benefits.
- Initial treatment Initial treatment for injuries would include the following:
- Emergency room treatment
- Urgent care visit
- Initial doctor’s visit
- Hospital treatment Your injury may require surgery or for you to be admitted to the hospital. Plans will often pay benefits for these types of treatment that you receive in a hospital:
- Surgery
- Hospital admission
- Hospital confinement
- Intensive care
- Rehabilitation unit
- Transportation/lodging assistance Your accident may require an ambulance to transport you to the hospital for treatment. You may also incur costs traveling to and from your treatment facility. Some plans will pay benefits for your transportation and lodging for an overnight stay.
- Ambulance
- Air ambulance
- Transportation to and from your home
- Lodging (hotel)
- Specific injuries Payments for specific injuries vary by the injury and how severe it is. For example, a broken finger might have a payment of $100 while a broken leg might pay $1,500. Specific injuries that might pay benefits are these:
- Fractures
- Disclocations
- Burns
- Concussions
- Emergency dental work
- Lacerations
- Tendon/ligament/rotator cuff injuries
- Follow up care Follow up care is what you receive after your initial treatment for the injury. For example, you might break your toe and then go back to the doctor for a follow up visit to check on how it is healing. You may also require a special boot which is a medical appliance and a follow up x-ray. These are all examples of follow up care. Others are:
- Follow up with the doctor
- Medical appliances
- Physical therapy
- Diagnostic exams
- Prosthetic devices
- Accidental death & dismemberment Many accident plans also include a benefit if you happen to die in an accident. If you lose a limb, the policy may also have dismemberment benefits.
- Wellness screening benefits Wellness screening benefits may also be a benefit of the policy. Benefits usually range between $50-$200 dollars. You qualify for a wellness benefit if you get a qualifying wellness screening each year.
As you can see, the schedule of benefits in an accident policy has several different types of payments that you might qualify for.
Accident plans are not reimbursement plans
One thing to keep in mind about an accident plan is that benefits are limited to what is listed in the schedule of benefits.
Let’s say that an accident plan pays a $300 benefit if you go to the emergency room for treatment. When you receive the bill from the hospital, it likely be more than $300. Your other payments you receive according the sample schedule above may be more or less than the bills you receive for treatment.
Accident plans may not cover all of your out-of-pocket medical costs. It will just depend on the injury and the treatment.
But, it will provide some extra cash to help.
Organized sports benefits
Some plans pay extra benefits if an injury occurs during an organized sporting event. This would be important if you have children who play sports at school.
Typically, a plan might add 20% to the payment in the schedule of benefits for that specific injury.
Conclusion
Accident plans pay cash for injuries. The cash from these plans can help you pay the bills you receive for treatment.
If you have a high deductible on your medical plan, this can help you pay some of that deductible as well as the coinsurance after you meet your deductible.
If you participate in activities that put you at a higher risk of an accident like riding motorcycles, playing basketball or softball (or have children that do), an accident plan might be a good benefit to add to your elections at enrollment time.
Many employees also tell me they are accident prone and it provides peace of mind if something should happen.
