Accidental Injury Insurance
Accident Insurance will help you cover the medical expenses and out-of-pocket costs when you have an accidental injury. These plans typically pay any medical expenses, after a small deductible, related to the injury that your Texas health insurance policy doesn’t cover. These expenses include ER visits, x-rays, hospital stays, lab work, etc. Texas accident policies can come in two forms: stand-alone products or as an add-on to your existing medical insurance policy. Some carriers that offer these as an add-on would be Humana, United Healthcare, and Independence Holding Corporation (which is our most popular temporary health insurance carrier). Our most popular offering on a stand-alone basis would be from NACD.
Some plans will pay the actual accident benefit(s) directly to the provider or will just reduce the cost of any deductible/out-of-pocket expense if the plan is through the same insurance carrier as your health insurance policy in Texas. Alternatively, some plans will just reimburse you directly for expenses that you’ve already paid as long as you have receipts for payment and any applicable medical records to prove payment and treatment.
Accident plans are typically issued with no underwriting as they are “guarantee issues”. Most people under the age of 70 will be eligible to purchase an accidental injury policy and any dependent children are eligible up to age 26.
Most accidents from participation in sports will be covered under your accidental medical and, if included, air ambulance benefit. As a general rule, any accident from participation in semi-professional sports or professional sports will not be covered. Also, and this should be obvious, any accident related to alcohol, drugs, or incurred while committing a felony, would not be covered.
Most accidental medical benefits are considered “full excess” benefits meaning that if you incur a covered medical charge, the accident insurance carrier will pay the applicable benefit, subject to any deductible that is more than the amount payable from your Texas health insurance policy. This does not require enacting the coordination of benefits provision contained in most health insurance policies.
Accident policies can be purchased as an individual, family, or on an employer group insurance basis. Many employers are beginning to offer these as a supplement to higher deductible group health policies.
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