According to a 2018 study over 35 million visit an emergency room with an injury each year¹. Accidental injuries seem to happen when we least expect them. However, with accident insurance you can receive coverage for an unexpected injury, so you are not stuck paying so much out of pocket. Accident insurance pays you a direct cash benefit if you suffer an unexpected qualifying injury. This benefit can be used in any way that you like, to pay bills, for childcare, and any other expenses that you may have.
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Accident insurance is designed so you can pay for things that just aren’t covered by your major medical insurance. It is not intended nor designed to be a replacement for major health insurance because accident insurance only covers qualified injuries, not chronic illness, or diseases such as cancer.
Should I get accident insurance and are there limits to the coverage?
Accidents are a part of everyday life. However, with the high cost of deductibles for health care coverage, it can be difficult to pay for medical expenses if you or a family member are hurt and must miss work. Accident insurance is a supplemental insurance policy that helps cover expenses that your health insurance doesn’t, such as your deductible, groceries, and even your mortgage. That means that you don’t have to choose between your health and putting food on the table.
As with all insurance products there are limitations to your coverage with accident insurance. Your coverage typically is limited to a pre-determined number of payouts over a set period. The type and severity of injury play a role in the size of benefit that you receive. Typically, injuries that are more severe and require more time out of work will have a higher benefit. Be sure to fully understand what your plan does and does not cover before purchasing.
There are also limitations to the types of accidents that are covered, typically accidents that occur while engaging in a risky or illegal activity are not covered. It is a good idea to make sure that you understand your plan before you purchase it, including what is covered, cost of monthly premium, and the amount that you receive for different injuries.
What’s the difference between hospital indemnity vs accident insurance?
Hospital indemnity is another type of coverage that covers you if you are injured unexpectedly. With hospital indemnity you are paid a direct cash benefit if you need to go to the hospital, however, if you do not go to the hospital, you receive no benefit². This means that you will not be covered for minor injuries that do not require a hospital visit yet still be expensive. Accident insurance is different.
Not all injuries require a trip to the emergency room, however, this doesn’t mean that they are not serious and expensive. With accident insurance you receive your cash benefit regardless of where you receive treatment if the injury is listed in the policy. Injuries such as concussions and some dislocations may only require a trip to your doctor, not a hospital, with accident insurance these may still be covered. This means that you have more flexibility in terms of where to get care and the level of care that you need.
If voluntary accident insurance is worth it, why buy similar coverages?
When accident insurance is offered as a benefit through your employer it is called voluntary accident insurance, but paid for by employees, via payroll deduction³. If employees wish to enroll in the coverage, the premiums are deducted from their paychecks. With voluntary accident insurance coverage, you must buy coverage during your open enrollment period.
Although it may seem like an easy choice to go with your employer’s voluntary accident insurance policy over a private supplemental plan, it is important to compare the benefits of both. Sometimes employer sponsored plans are typically one size fits all whereas a private accident insurance plan may have more options. You may also have the option to add even another layer of protection in by purchasing a supplemental accident insurance plan in addition to your employer sponsored plan. This can be useful if the benefits provided in your voluntary accident insurance plan are minimal.
For people who are self-employed it is important to note that accident insurance does not replace major health insurance. Accident insurance is designed to be an add-on to your current health plan, covering aspects that your health plan does not. Accident insurance does not cover illnesses or chronic injuries that are typically covered by your health insurance plan, it only covers injuries that occur as the result of a qualifying accident.
How to know if supplemental accident insurance is worth it and whether it’s the same as accidental death and dismemberment insurance (AD&D)?
Supplemental accident insurance is designed to give you a cash benefit if you have an unexpected qualifying injury. Most accident insurance plans cover some injuries but not others. Accident insurance through Guardian Direct® covers a wide variety of qualifying injuries including:
Emergency Room Treatment
Emergency dental work
This is different from accidental death and dismemberment, or AD&D insurance. With AD&D, coverage is only applicable if the injury causes death or severe dismemberment resulting in the patient being permanently injured such as in the case of a spinal cord injury or the loss of a limb. If you have a serious injury that doesn’t fit this description, with AD&D you will be required to pay for all of your expenses out of pocket.
In addition to the types of injury that are covered it is also important to note restrictions on the types of activities that are covered as well. Extreme sports such as skydiving and parasailing, or injuries sustained while under the influence or while engaged in an illegal activity are not covered under most supplemental accident insurance plans.
Accident insurance is considered a supplemental insurance, meaning that it is not required but may be beneficial. Accident insurance is particularly valuable if you are living an active lifestyle where your risk of accidental injury is elevated. This coverage can also be beneficial for people who are getting older and may be more prone to accidental injuries.
It also can be a good idea to consider accident insurance if you have children who are enrolled in youth sports. While being active is an essential part of being a kid it also can lead to more injuries. Having accident insurance can help you pay for expenses if your child is injured, and you need to stay home from work. This allows you to focus on getting your child healthy rather than worrying about how to make ends meet.
If my employer doesn’t offer this coverage does that mean personal accident insurance is worth it?
A voluntary accident plan through your employer is typically limited to ages 18 to 70 or higher, and covers dependents through their late 20’s⁴. With accident insurance purchased on your own typically there is no underwriting, which makes purchasing a plan quick and easy. The qualifying ages for accident insurance vary depending on your plan and carrier.
The monthly premiums for accident insurance tend to be low, between $6 and $20 per month depending on your carrier and plan⁵. This makes supplemental insurance an affordable addition to your major health care plan. Additionally, accident insurance help you cover items that are not covered by your health insurance, such as bills, groceries, your deductible, therapy, and anything else that you may need. If you have children, depending on the plan, you may be able to add them so if they get injured you can receive a benefit for the time that you must take off from work.
What does accident insurance mean & Insights
Accident insurance is insurance that covers you if you suffer an unexpected injury, it doesn’t mean that you are covered for disease, illness, or chronic issues like arthritis. Supplemental accident insurance is not designed to replace your major health care plan.
Whenever you are shopping for insurance, it is important to do your research so that you understand all aspects of an insurance product. Guardian Direct® has a large library of accident insurance articles that can help educate you on a variety of accident insurance topics. Informing yourself before you purchase a plan helps ensure that you make an informed decision for your family’s health and your budget.
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https://www.cdc.gov/nchs/fastats/emergency-department.htm (2018) accessed June 2021
https://www.bankrate.com/glossary/h/hospital-indemnity-insurance/ accessed June 2021
https://www.healthinsurance.org/glossary/voluntary-accident-insurance/ accessed June 2021
https://www.policygenius.com/disability-insurance/what-is-accident-insurance/ (2019), accessed July 2021
https://www.policygenius.com/disability-insurance/what-is-accident-insurance/ (2019), accessed June 2021
Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.05/22)