Guide to Accident Health Insurance Plans in the United States
Accident health insurance plans are attracting a lot of attention in the supplemental accident coverage market because it’s so practical. This type of personal injury insurance plan falls into the indemnity category rather then the insurance category. Indemnity’s compensate you for damage, loss, or injury in cash payments to you directly or the health care provider. These plans are guarantee issue and require no health questions when enrolling. Americans who have this clever type of accident plan receive benefits with any doctor, emergency room hospital, or urgent care type facility. Members can choose a benefit amount (policy face value) of $2,500, $5,000, $7,500, or $10,000. These principal sum benefits are paid per accident (per injury). Typical deductible (deductible is the dollar amount person must pay before insurance company pays) is $100 dollars and all other hospital bills are paid up to the policy max. If someone has the $10,000 benefit accident plan and gets injured, resulting into a a $10,000 dollar ACL knee surgery, it could potentially only cost the member $100 dollars out of pocket. Member can also choose any surgeon for the procedure which is comforting.
Personal accident insurance are membership plans that have monthly dues. These association benefits clearly state they are not insurance but a type of accident medical expense plan. Coverage is for bodily injuries and not disease or sickness. Emergency room coverage is the core focus. Other names for this type of plan include supplemental accident coverage, emergency room insurance, accident medical expense benefit, accident health insurance plan, 24 hour accident coverage, and accident medical coverage. Anyone who’s had a high deductible insurance plan knows that a lot of bills come from the emergency room.
Association based membership benefits isn’t anything new. The main benefit to these plans are affordable monthly dues, everyone qualifies, and benefits are paid in conjunction with any licensed medical care facility or doctor. The applications don’t have any health questions during enrollment but automatic acceptance is only up to age 64 or 70.
Everyone being able to qualify for a personal accident insurance plan is a good thing. Flexibility for members to choose any doctors office, medical clinic, or hospital emergency room makes sense because this is a type of accidental injury policy. When I was researching these plans and gathering all the sales brochures, having the ability to choose any doctor, clinic, or hospital ER was consistent and true. The accident medical coverage usually has a $100 dollar deductible and a per member coverage amount of $2,500, $5,000, $7,500, or $10,000. Plans pay part of the bills you are charged at the doctor, hospital, ER, up to the maximum benefit chosen per covered injury. Another way to phrase that is a personal injury insurance plan pays for all bodily injuries from a accident, less the $100 deductible, up to the maximum benefit of $2,500, $5,000, $7,500, or $10,000.
In most circumstances these plans pay accidental injury benefits. Except for injuries a member sustains while under the influence of drugs / alcohol, during act of war, or if also covered on workers compensation. These are standard rules for just about any health insurance product. Injury benefits are paid to members per incident or per injury. During coverage, each accident is treated as a new event with new benefit payments, but subject to another $100 dollar deductible. Benefits are paid directly to members or the health care provider. Some plans only pay the health care provider, and other plans clearly state they pay the member directly. You’ll have to review the policy to see how payment is handled.
Specific benefits covered by this type of personal injury insurance plan include: doctors fee for surgery (inpatient or outpatient), ambulance expenses, doctors visits, hospital emergency room care, anesthesia services, prescription drugs, nurse expenses, hospital confinement, operating room, laboratory tests, x-rays, MRI’s, dental treatment to sound natural teeth, physical therapy, hospital room and board.
During my research of checking out dozens of these accident insurance plans it was interesting to find out that a lot of these plans are underwritten by Guarantee Trust Life Insurance Company. This means that Guarantee Trust Life is “backing” this type of personal accident coverage and that hundreds of health insurance firms are marketing the plans for them. So there are a lot of different agencies selling these plans but the trail leads back to one main insurance company. Guarantee Trust Life Insurance Company has been around for 70 plus years and is located at 1275 Milwaukee Ave. Glenview, Illinois 60025. Of all the different firms selling these plans the best rates I’ve found so far is the following.
For individuals, a $5,000 benefit plan is around $22 a month, $7,500 benefit is $28 a month, and a $10,000 is $34 dollars a month. For families, $5,000 benefit is $35 a month, $7,500 is $41 a month, and $10,000 is $47 dollars a month. The $10,000 accident benefit plan at $47 dollars a month includes the entire family. Even if the family has six members, it’s still $47 a month total. Bigger the family, the more that $47 a month membership stretches. Anyway you look at it, that is a lot of useful real world coverage for that price.
Personal accident insurance plans are sold by some health insurance agents to compliment their clients HDHP (High Deductible Health Plan). Due to medical inflation and the constant rate increases from insurance companies, typical deductibles these days are $5,000 and $10,000. Deductible is the dollar amount a covered person must pay before the health insurance policy kicks in. This basically means the insured has to come up with that $5,000 or $10,000 dollars before the policy pays anything. This is where the common complaint that “my health insurance plan doesn’t pay anything” comes from. What people are saying is that when they rush to the emergency room from a accidental injury, odds are they will be paying that deductible out of pocket on top of the expensive premiums every month. It’s for this reason that emergency room insurance plans offset that deductible exposure. Plans help pay the expenses associated with accidents which is realistic. This upfront accident coverage can pay off that huge deductible. In short, these accident insurance policies fill in the gaps perfect with the catastrophic high deductible plans being offered in the United States. Picking up a accident plan as a “stand alone” supplement is equally as smart.
Adam Santi has been a licensed medical insurance broker since 2004. Adam is also a Gracie Jiu-Jitsu Black Belt and is an expert on getting himself injured, tapping out, and going to the local emergency room. Check out my website to apply online to the industries leading accident health insurance supplement.