| Personal injury insurance supplements are available to | | | | pocket exposure that many HDHP (High Deductible |
| Americans up until around age sixty five. This | | | | Health Plans) have. Major medical insurance |
| emergency room coverage has no health questions | | | | companies in the United States seem to be doing "rate |
| when applying and the accident medical coverage is a | | | | adjustments" (rate increases) every 12 months. Every |
| guarantee issue. These clever plans have many | | | | health insurance client I have who has a PPO |
| nicknames including supplemental accident coverage, | | | | Catastrophic style plan gets rate increases every year |
| 24 hour accident plan, emergency room insurance, and | | | | even if they don't file a single claim. In fact, the only |
| personal accident insurance supplement. Plans are not | | | | way you won't get a rate increase with a PPO in the |
| marketed as insurance, rather an association based | | | | United States is by purchasing an optional upgrade for |
| Indemnity. Indemnity's compensate people for a loss up | | | | a "Rate Guarantee". Rate increases every 12 months |
| to a predetermined amount. In this case, personal injury | | | | have forced Americans to increase the deductible to |
| insurance indemnity pays up to a benefit (policy face | | | | keep monthly premiums affordable. Typical deductibles |
| value) of $2,500, $5,000, $7,500, or $10,000 US dollars | | | | now a days is $5,000 or $10,000. |
| per accident. | | | | The problem with such a high deductible is that any |
| Since plans are technically not insurance, members | | | | bodily injury resulting into a ER visit will max out the |
| pay association dues which give members access to | | | | deductible. A $10,000 dollar hospital bill is one broken |
| accident medical coverage. The limited accident health | | | | bone away even if you have a 5 Million dollar lifetime |
| insurance plan only covers bodily injuries and not | | | | max PPO. A large percentage of health insurance |
| sickness. Incredibly, accident benefits can be used with | | | | deductibles are met from emergency room claims. |
| any licensed doctor, hospital emergency room, urgent | | | | Broken bones, torn ligaments, severe lacerations are |
| quick care facility, or medical clinic. Freedom to use any | | | | everyday events and will most likely be the reason for |
| doctor or hospital is because it's injury coverage. | | | | that deductible to be used up. It's for this reason that |
| These plans would be useless if members had some | | | | educated health insurance agents have been |
| lame network provider booklet to choose from in a | | | | suggesting ER supplements to their clients for years. |
| trauma situation. Plans cover members outside of the | | | | Plans provide up front accident coverage that can be |
| United States for up to sixty consecutive days and | | | | used to pay off that $5,000 or $10,000 deductible. |
| can be used as a form of travel insurance while | | | | Helping pay the out of pocket bills associated with |
| abroad. Keep your out of country vacations down to | | | | accidents is the core benefit. |
| two months at a time, and policies cover accidental | | | | Most accident plans used in conjunction with HDHP's |
| injuries up to benefit level of $2,500, $5,000, $7,500, or | | | | will only cover up to the HDHP deductible. So it doesn't |
| $10,000 per accident. Most likely, if you get injured out | | | | make any sense to have a $2,500 deductible with Blue |
| of country the personal accident insurance plan | | | | Cross Blue Shield (just an example) and a $10,000 |
| provider will reimburse you the bill when you return | | | | benefit accidental injury plan since the plan will only pay |
| home and you'll need to provide a proof of loss, which | | | | up to $2,500 to match the Blue Cross deductible. What |
| is a copy of the hospital bill while traveling abroad. | | | | does make sense is to increase your current PPO |
| Accidental injury benefits are either paid directly to the | | | | deductible to the face value of the accident insurance |
| health care provider that treated you, or plans | | | | plan and save a ton of cash every month on health |
| compensate you directly to cover the bill. Some | | | | insurance. So if you pick up a $10,000 benefit injury |
| accident health insurance supplements only pay | | | | plan, you might as well increase your current PPO |
| members for loss and others pay off the hospital or | | | | deductible because odds are if you ever meet that |
| doctor for you. Plans pay hospital, doctor, or other | | | | deductible it will be from a bodily injury. A virtual zero |
| injury related expenses you are charged, up to the | | | | deductible effect is what your looking for here. So a |
| maximum benefit amount selected, less the deductible. | | | | accident plan not only insures the high deductible but |
| Typical deductibles are $100 to $250 dollars. Deductible | | | | also give you the stress free decision to increase the |
| is the dollar amount you / member pays before the | | | | PPO deductible and possibly cut the health insurance |
| insurance plan pays. In other words, this style of injury | | | | premium in half. If you don't have a major medical |
| insurance pays up to $2,500, $5,000, $7,500, or $10,000 | | | | insurance plan in place, picking up a injury policy as a |
| US dollars with a $100 deductible, per covered injury. | | | | stand alone is a good idea. |
| Benefits are payed per accident or per injury meaning | | | | Outpatient surgeries is one of the best uses of these |
| every claim you file is treated as a separate event | | | | supplements. Usually when someone suffers a non life |
| and benefits reset. If you have a $10,000 benefit | | | | threatening bodily injury they have time to plan out the |
| accident plan, and subsequently have a injury resulting | | | | surgery. During the initial ER visit the doctor reviewing |
| into a $10,000 ER bill, your out of pocket expense will | | | | the MRI or X-Rays will tell you if the injury needs |
| be $100 bucks. That's the beauty of indemnity plans. | | | | surgery. A lot of injuries need surgery in order to heal |
| Ballpark figures from the leading accident plans in this | | | | correctly. For example, let's say someone lands on |
| health insurance supplement niche are the following. Of | | | | their shoulder hard and the trauma causes a very |
| course every insurance company does rate increases. | | | | common sports injury called a AC Joint Separation. |
| However, these are not in that category so | | | | AC joint separation is a shoulder injury when the |
| membership plans rate increases do happen but not | | | | ligaments in the shoulder separate from the hard blow. |
| every 12 months like PPO carriers. So far, rate | | | | This type of injury sometimes should be surgically |
| increases with this type of bodily injury insurance | | | | corrected to properly align the ligaments during healing. |
| supplements are rare. | | | | Surgery also helps people get back to sports and a |
| Individual Policy: $5,000 max benefit - $22 monthly. | | | | healthy lifestyle. One huge benefit with personal ER |
| Individual Policy: $7,500 max benefit - $28 monthly. | | | | plans is being able to choose the surgeon for the |
| Individual Policy: $10,000 max benefit - $34 monthly. | | | | outpatient surgery. In this shoulder injury example, |
| Family Policy: $5,000 max benefit - $35 monthly. | | | | having the AC joint separation surgery with the best |
| Family Policy: $7,500 max benefit - $41 monthly. | | | | Orthopedic Surgeon around is a great luxury. |
| Family Policy: $10,000 max benefit - $47 monthly. | | | | Preferably a Surgeon who specializes in Sports |
| (Family monthly dues include everyone. It's the same | | | | Medicine and works with professional athletes. If you |
| price if you have a 3 person family or a 10 person | | | | are injured with an accident plan in force, seek out the |
| family). | | | | best doctors since you'll only be paying the deductible |
| Specific personal injury insurance benefits covered: | | | | anyways. |
| -Physician surgical fees (inpatient or outpatient) | | | | So what are the draw backs? Accident insurance |
| -Emergency room | | | | plans only pay for injuries that occur after policy is in |
| -Doctor visits | | | | force. Even though plans are guarantee acceptance, |
| -Ambulance | | | | any claims you file or injuries that result in a financial |
| -Nurse | | | | loss, are only payable after policy is active. Someone |
| -Physical Therapy | | | | simply can't purchase a personal accident insurance |
| -Operating room (inpatient or outpatient) | | | | plan after an injury and try to get the surgery paid for. |
| -Anesthesia | | | | This is health insurance rules 101 but worth mentioning. |
| -Laboratory testing | | | | Professional and College level sports injuries are no |
| -Dental treatment for injured sound natural teeth. | | | | covered either. Plans do exist for professional athletes |
| -Room and board for general hospital confinement | | | | but this isn't one of them. Also, injuries relating to adult |
| -Prescription drugs | | | | competitions have some gray area. Kids league sports |
| -MRI's | | | | like little league baseball, youth soccer, and high school |
| -X-Rays | | | | sports (including football) are covered on the best |
| -Casts, Crutches, Splints, Braces. | | | | plans. If your a parent, review the plan carefully and |
| -Blood plasma | | | | make sure policy covers kids sports leagues. Kids and |
| -Rental of durable medical equipment | | | | emergency rooms are almost synonyms, especially if |
| One of the most common uses for this form of | | | | children are involved in youth sports. Personal injury |
| emergency room insurance is to offset the high out of | | | | insurance plans cover this gap well. |