What Is Accident Insurance, and Do I Need It?

Accident insurance helps bridge the gap between what health insurance covers and the additional costs of treating an injury. Injuries are prevalent around the country, and health insurance seems to cover less and less. What happens is health insurance will pay for the initial care of the injury, such as emergency medical care, but will not cover ongoing care expenses. After an injury, you need follow-up care to get back on your feet, and when you cannot get the care you need, it gets worse, or you will reinjure yourself. Accident insurance aims to cover some financial strain that health insurance does not.

Accident insurance is not health insurance

Accident insurance is not health insurance; it is meant to enhance the benefits you get, not replace them. Health insurance will begin paying for your medical costs after you pay your deductible. Depending on your plan, deductibles can be high, and you might not have the funds for such a high copay or deductible. However, when you tap into your accident insurance, you can use the cash payout for the copays or deductibles, especially when they are on the higher end.

While health insurance requires you to visit doctors within their network, the same does not go for accident insurance plans, where you can see whomever you want and still access benefits.

What is covered under an accident insurance policy?

You can get an accident insurance policy that covers you or your family, and each policy will vary depending on its benefits. Injuries that are covered under these policies also vary, as will exclusions and premiums. There are no copays, and if there is a deductible, it is typically less than $250. The cash benefits you receive will vary by the severity of your injury and the type of accident. If you have a child in sports, there are individual plans to account for these circumstances, often with a higher premium. Other plans are guaranteed issue, meaning you do not need to undergo a medical examination to purchase the plan. You can continue to access benefits if you make payments on the plan.

The injuries that accident insurance covers include but are not limited to:

• Eye injuries
• Dental injuries
• Dislocations
• Concussions
• Burns
• Lacerations
• Fractures

The policies will cover equipment, procedures, and other costs incurred by the incident. It also covers ambulance transport, emergency room, and diagnostic testing. You can use cash benefits for groceries, rent, utilities, and childcare costs that may have gotten you behind when you were unable to work.

How does accident coverage work?

Accident insurance pays cash benefits to cover out-of-pocket expenses after an injury. So, if your health insurance does not cover some costs and you need to pay out of pocket, you can receive cash as reimbursement or help pay for these costs. You can get coverage at any time of year, and there is no open enrollment period or the need to prove a qualifying life event. Once you sign up for coverage, it will begin within a few days or weeks, and you can cancel anytime. Be careful, as some insurance companies have other guidelines for accessing these benefits.

As with all insurance policies, exclusions apply, and accident insurance does not cover preventative care or prescription medication. It also does not cover any pre-existing injuries; you will need to work with your health insurance policy to receive coverage. Always check your plan documents for relevant exclusions. Additionally, most, if not all, accident insurance policies do not cover injuries resulting from known risky activities like:

• Self-harm
• Auto racing
• Illegal activities
• Athletic competitions (semi-pro and professional)
• Skydiving
• Hang-gliding

Other inherently dangerous activities can also lead to exclusion and lack of benefits. Accident insurance is more affordable than health insurance and is usually within the $5 to $50 monthly range. Depending on the insurer and plan options, the prices will vary. You can purchase these benefits independently or through an employer.

Alternatives to accident insurance

Accident insurance seems like a great addition to your health insurance policy because it offers you additional protection during an accident. However, it is not the only alternative insurance coverage available. Another insurance policy you can purchase is fixed-indemnity insurance, which pays a preset amount for specific events like surgery. You can even purchase a hospital indemnity plan, covering illnesses and injuries, that kicks in when you are admitted. Medicare recipients can also purchase Medigap insurance, which helps pay for Parts A, B, and D.

Filing claims in Hanover, PA using an accident insurance policy

If you suffer an accidental injury, you can file a claim. Ensure it is a qualifying injury, however, so you do not see a claim denial. You only have a set amount of time to file, so check the deadlines in your policy. You must fill out a claim form and provide supporting documents about your injury. Additionally, the doctor you are seeing will need to give a detailed account of your injury and treatment plan. Unlike some insurance policies, you will receive a decision within weeks and, if approved, get a check made directly to you.

Accident insurance has many benefits, especially when it works cohesively with your health insurance plan. Your health insurance coverage and lifestyle depend on whether it is the right fit for you. Additionally, if you are in an accident that was the result of negligence, you can also file a personal injury claim. Call KBG Injury Law in Hanover at 717-848-3838, or complete our contact form to determine whether you should file a personal injury claim in addition to your health and accident insurance claim. We have additional offices in York, Lancaster, Harrisburg, and Gettysburg.