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Q&A: Everything you need to know about accident insurance
Is your employer offering accident insurance as part of your benefits package, or are you considering purchasing an accident policy directly from an insurance agent or broker? You may have questions about this coverage and wonder if it’s worth it. Check out this helpful Q&A to learn everything you need to know about accident insurance!
Q: What is accident insurance?
Accident insurance is a type of supplemental health insurance that pays cash benefits for common accidental injuries that send you to the emergency room, urgent care or doctor’s office. Benefits vary from company to company, but many accident insurance products cover a wide range of medical services, plus specific injury benefits.
| Examples of Medical Services possibly covered: · Hospital confinement · Intensive care unit confinement · Emergency room services · Ambulance ride · Transportation · Family lodging · Physician office visit · Rehabilitation facility · Outpatient therapy · Medical imaging · Medical appliances · Prosthesis · Blood and plasma · Pain management | Examples of specific injuries possibly covered: · Factures · Dislocations · Lacerations · Injuries requiring surgery · Paralysis · Burns · Emergency dental work · Concussion · Coma · Dismemberment · Accidental death |
Q: How are benefits paid?
Accident insurance is meant to be purchased in addition to your primary policy, and it pays benefits regardless of your current plan. It’s different than major medical insurance because benefits are paid directly to you, not to doctors or hospitals. With cash in hand after an injury, you can use the money for ANY purpose, including medical bills and living expenses. Here’s how most policies work:
1. An unexpected injury happens: You’re driving to work when you’re t-boned on the driver’s side.
2. You need medical care: An ambulance takes to you to the hospital. X-rays reveal you have a broken arm, plus you have a concussion and need stitches.
3. Accident insurance helps when you need it most: You file a claim and receive cash benefits for your ambulance ride, emergency room services, hospital stay, medical imaging, broken bone, stitches and concussion. You use the money to help cover your out-of-pocket medical bills and time off work to heal.
Q: Why do you need accident insurance if you already have Medicare or major medical insurance?
Medicare and major medical insurance that you get through work or purchase independently usually provide good coverage, but they probably leave you exposed to out-of-pocket costs, such as:
- Deductible: Before your major medical starts paying benefits, you must meet your deductible. The average annual deductible for employer-based health insurance is $2,004 for single coverage and $3,686 for family coverage.1
- Copays: These are fixed amounts you pay for covered services after you meet your deductible. For example, a policy could have a $300 emergency room copay.
- Coinsurance: This is a percentage of covered health care costs that you must pay after your deductible is met, such as 20%. Considering that example, someone who pays 20% coinsurance would owe $2,000 after a $10,000 hospital stay.
Q: What are the odds of actually using accident insurance?
Accidental injuries are probably more common than you think. In fact, one in five Americans seek medical attention for injuries every year.2
Q: Won’t workers’ compensation pay me if I’m injured?
Workers’ compensation only pays for work-related injuries or illnesses. Accident insurance helps cover injuries that occur on or off the job. Keep in mind that over 90% of all accidents in the U.S. happen outside of the workplace, at homes or in the community, where workers’ compensation doesn’t cover them.2
Q: How much does accident insurance cost?
Accident insurance premiums vary by plan and carrier, but are typically very affordable and comparable to nonessential items like coffee, fast food and cigarettes.3 Many people find accident insurance premiums to be negligible compared to the medical bills they may receive after an accidental injury.
Still have questions? We’re here to help!
Do you still have questions about accident insurance? For more information, call (800) 525-7662.
1Kaiser Family Foundation, Average Annual Deductible per Enrolled Employee in Employer-Based Health Insurance for Single and Family Coverage, https://www.kff.org/other/state-indicator/average-annual-deductible-per-enrolled-employee-in-employer-based-health-insurance-for-single-and-family-coverage/?currentTimeframe=0&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D, 2023.
2National Safety Council, All Injuries Overview, https://injuryfacts.nsc.org/all-injuries/overview/, 2023.
3Washington National, Understanding supplemental health insurance, 2021, p. 7.
Washington National is a private company that is not Medicare, Medicaid or MaineCare and is not a governmental agency