Emergency Room Insurance Supplements
Emergency room insurance supplements in the United States are a form of accident medical coverage that covers accidental bodily injuries. These plans have no health questions or underwriting, meaning everyone can qualify. Guarantee acceptance is usually until age 65. Since this is a form of accident insurance, plans can be used with any licensed doctor, emergency room, urgent quick care facility, or medical clinic. Some sales brochures might refer to these plans as 24 hour accident coverage, accident medical expense benefit, personal injury insurance plan, accident health insurance, or personal accident insurance. It should be nick named “pound for pound most useful plan” based on its practicality.
Supplements that provide this form of emergency room coverage are a membership based indemnity. A indemnity plan compensates for a loss in cash payments to member or medical care provider. Plans pay part of the medical expenses charged by doctors or hospitals up to a benefit amount of $2,500, $5,000, $7,500, or $10,000 per accident. Plans are not marketed as insurance, rather a limited accident medical expense policy. Plans are tied into a association that offers it’s members this type of emergency room insurance coverage. Coverage is for bodily injuries and not sickness related ER visits. On a good plan, injuries sustained in kids league sports like soccer, football, and baseball are covered. High school sports injuries are also covered on some plans. Professional or College level sports injuries are not covered. Just like any other health insurance plan, injury must happen while coverage was in force and directly caused a loss to you covered under the policy. So benefits are only payable if the policy was active before the injury occurred. Kids can stay on the family accident plan until age 26 when they’ll have to switch to an individual policy.
Since plans are not insurance but a association, applications have no health questions and acceptance is guaranteed. Emergency room coverage plans can’t have a strict “in network or out of network” set of rules. The ER supplement I’m writing about here can be used at any hospital, doctor, or clinic. Plans also can be used as travel insurance while outside the United States. Most plans only will cover abroad for two consecutive months. So if your vacation out of country go’s past 2 months, plan won’t cover any bodily injury claims. But who’s really worried about health insurance during a 2 month vacation?
Personal injury insurance plans pay for all injuries from any one accident up to the policy benefit of $2,500, $5,000, $7,500, or $10,000 minus a $100 dollar deductible. Deductible is the out of pocket expense you (the insured) pays before the accident plan pays. Put differently, members can choose accident medical benefits of $2,500, $5,000, $7,500, or $10,000 US dollars with a $100 deductible per occurrence. Currently, most injury plans have a $100 or $250 deductible. Indemnity benefits reset after each accident and benefits are paid per injury or per accident with a new $100 deductible.
Emergency room coverage includes:
-Hospital Emergency Room Care
-Operating Room Costs (inpatient or outpatient)
-Doctors visits (inpatient or outpatient)
-Doctors fees for surgery (inpatient or outpatient)
-Prescription Drug expense
-Dental treatment for injury to sound natural teeth.
-Miscellaneous hospital expenses during stay, outpatient surgery under general anesthetic.
-Hospital room and board
-General nursing care
Lowest plan rate found so far. Note: Many insurance agencies sell these accident plans packaged with dental, vision, and other random discounts. So these prices are just the policies for straight accident coverage.
Individual: $5,000 policy value – $22 monthly.
Individual: $7,500 policy value – $28 monthly.
Individual: $10,000 policy value – $34 monthly.
Family: $5,000 policy value – $35 monthly.
Family: $7,500 policy value – $41 monthly.
Family: $10,000 policy value- $47 monthly.
( Monthly price for a family policy includes everyone. It’s the same price if you have a 3 person family or a 8 person family).
Emergency room health insurance supplements in the United States are commonly used in conjunction with HDHP (High Deductible Health Plans) to cover the big deductibles. Typical PPO deductibles are up to $5,000 and $10,000 due to constant rate increases from insurance companies. Increasing the deductible every year offsets the annual rate increase. The issue people have with these large deductibles is that one emergency room visit from a broken bone or torn ligament will meet the deductible for the year. A lot of HDHP deductibles are maxed out from bodily injuries that required X-rays, MRI’s, and eventually surgery. Emergency room insurance plans pay out of pocket bills associated with accidents and can pay off the high deductible PPO plan. Combining a HDHP with a ER plan of the same amount will offset any claims resulting from bodily injuries.
One specific benefit worth highlighting is the surgical benefit. Members can pick any doctor. Of course the policy must be active before injury occurs. For example, let’s use one common sports injury like a torn ACL. This knee injury often needs a complete ligament replacement to get back to an active lifestyle. The torn knee ligament isn’t going to heal itself and for people who do sports and move around it’s a must. In this example, however you injured the ACL, the knee buckled and then you’ll hear a pop. The knee swells up and it just doesn’t feel the same. At least this was how my ACL tear went down. At this point, someone can go directly to an emergency room and get the MRI or X-rays.
Or they can schedule an appointment directly with a Orthopedic surgeon. Either way the next step is diagnostic testing to see what the damage is. If the diagnosis is a torn ACL, you’ll have time to schedule surgery as an outpatient. Ask some Physical Therapists in your area who the best Orthopedic Surgeons are for ACL reconstructions. Physical Therapists know exactly who the top doctors are because Therapists are the first person to see patients post operation. Surgeons who do Sports Medicine and work with professional athletes are the elite. Contact the doctors office and get quoted for the ACL repair. In a lot of common sports injuries the emergency room insurance policy face value of $10,000 dollars will pay off the entire surgery and the post operation physical therapy. Total out of pocket expense would be the plan deductible ($100 or $200). Not to mention the best knee surgeon in the state took care of you.