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.
