|
Examples of how the accident plan works
Example
1: $5000 accident plan purchased as a supplement
to a high deductible health plan.
This example assumes that your family has
a $5000 PPO health plan deductible and on top of that you purchased the
$5000 (Basic Plus) Accident Plan. The $44.95 rate covers your entire
family with $5000 in accident coverage. Your daughter is playing soccer
and falls. You take her to the emergency room and she is diagnosed with
a broken arm. She is put in a cast and all said and done, the bill
comes to $2,200. The hospital bills your insurance company. Your
insurance company notifies you via an Explanation Of Benefits letter (EOB) that
you have a deductible of $5000 and thus, you are responsible for the
entire $2,200 bill. Soon after you get a bill for the $2,200 from the
hospital for the unpaid claim.
You now submit your accident claim
($2,200) to the accident plan carrier and you receive a check for $2,100
because you have a $100 deductible with your accident plan. You then pay
the $2,200 bill using the money you received from the accident
carrier plus $100 of your own money. Total out of pocket to you is
only $100.
Secondary benefit... your health
insurance company has recorded that you have satisfied $2,200 of your
$5,000 PPO plan deductible, leaving your remaining deductible at only $2,800 for
any future accidents or illnesses.
Example 2:
$5,000 accident plan purchased as standalone plan.
No other insurance involved.
You're a self employed roofing contractor
and your business has suffered a financial blow due to the down economy.
You are forced to let your expensive health insurance policy lapse, but
decide to purchase the $10,000 accident plan, just in case you have an
accident. Total premium is $64.95 per month for you and your family,
which you can afford.
Sure enough you lose your balance
climbing your ladder and hit the ground off balance. You suffer a broken
ankle and receive a $2.900 bill from the hospital's emergency room
center. You submit the ER bill to the accident plan carrier and you
receive a check for 2,800, since you had a $100 deductible. You use that
money plus $100 of your own money to pay the $2,900 bill from the
emergency room visit.
Furthermore, upon follow up to an
orthopedic surgeon, you are told that you will need a minor outpatient
surgery to repair torn ligaments in your ankle. You negotiate with the
orthopedic center and they agree to accept the remaining $7,200 of
accident coverage as payment in full. You sign paperwork assigning them
to receive payments directly from the accident carrier and you are cleared to
have the surgery performed with no additional money out of pocket.
Click here to see all benefits and pricing for your state
Download brochure
(when you are ready, we suggest the
online enrollment)
|
