Emergency Room Insurance Plan Review

Emergency room insurance coverage is tricky business even for people with health insurance. Americans who currently have a Major Medical PPO plan have been increasing deductibles every year to keep up with the annual rate increases. PPO stands for Preferred Provider Organization and they are supposed to be the “good guys” who let people pick their doctors. Deductible is the out of pocket expense the insured pays before the health insurance plan pays. $5,000 and $10,000 dollar health insurance deductibles are now considered normal. Increasing the deductible is a good strategy of keeping monthly premiums down. Major medical insurance companies are supposed to insure the big stuff like Organ Transplants, Heart attacks, and Cancer. But what about the everyday stuff like bodily injuries that need immediate attention at emergency rooms?

A major complaint about these $5,000 and $10,000 catastrophic plan deductible is “my health insurance doesn’t pay for anything.” This means any time someone has a bodily injury and uses the health insurance they could be looking at a $10,000 dollar deductible bill. The weakness of the high deductible health plan is covering the upfront emergency room expenses which is most probable. A large percent of PPO plans meet deductibles from emergency room bills. One broken bone and that $5,000 deductible is maxed out. PPO health insurance companies do offer “emergency room riders” that can be added onto the plan, but the optional benefit is sometimes hard to locate on the applications. Prices for the ER rider with current PPO companies are well priced but seem to have more rules and fine print. Personal accident insurance plans purchased by itself are better because it’s super portable and can literally follow you around the world. Accident plans typically will cover injury expenses while outside the United States for up to 60 consecutive days. Keep vacations abroad under 2 months and your cool.

So you can see, even people with a $5 Million dollar PPO plan are still paying out of pocket for ER visits. Health insurance savvy consumers have been purchasing emergency room insurance supplements for years. The personal injury insurance plan pays out of pocket expenses relating to bodily injuries and can pay off the high deductible PPO. The accident benefits cover the $5,000 or $10,000 deductible where its most vulnerable… emergency rooms.

Accident health insurance supplements aren’t insurance at all. They are an indemnity and plans are marketed as a limited accident medical expense benefit. Indemnity plans compensate the insured for losses in cash payments to member or the health care provider. In English, plans either pay off the hospital or doctor for you, or reimburse you (pay you) directly. Indemnity’s are nice because they pay “first dollar” and in this case, the deductible is usually $100 to $200 dollars. So a $10,000 benefit personal accident insurance plan pays for all covered bodily injuries up to $10,000 per accident, minus a $100 deductible. It’s kind of the opposite of a High Deductible PPO because ER plan deductible is small and plan pays benefits immediately. Combining both, high deductible PPO plan and a personal injury insurance plan will lower your overall monthly insurance premiums and lower the policies out of pocket risk.

Membership based accident health insurance plans have member dues instead of traditional health insurance premiums. Rate increases are seldom with ER plans. The association is a membership based organization that does a respectable job helping Americans get access to the highest level of health care. In particular, the accident medical expense benefit is very realistic and everyone can qualify for a plan. Accident plans have no health questions with the online applications and automatic acceptance is up to age 65 or 70. Not only can any American qualify, but accident plans can be used with any licensed doctor, hospital, ER, or clinic for bodily injuries. Plan works well with outpatient surgery because member can choose any Orthopedic Surgeon. If the ER doctor does an MRI or X-ray, and says the damaged body part needs surgery, take your time and find the best surgeons. ER plan must be in force prior to injury, if this is the case you’ll be able to get the surgery paid for up to policy max at any doctor.

Accident insurance plans can be used anywhere because of the nature of accidental injuries. Being “in network or out of network” is unacceptable. Injury benefits must be 100% portable because who knows where an injury will occur. This type of emergency room coverage works outside the United States up to 60 days abroad. So any out of country vacation under 2 months will be covered for accidental bodily injuries up to policy face value. Accident plan benefits (face value) available are $2,500, $5,000, $7,500, and $10,000. Benefits are paid per injury meaning benefits reset every time you file a claim. Huge benefit that indemnity’s have is by treating each accident as a totally separate event.

Current monthly dues from leading accident plan: (Estimates)

Individual: $5,000 injury benefit $22 a month.
Individual: $7,500 injury benefit $28 a month.
Individual: $10,000 injury benefit $34 a month.

Family: $5,000 injury benefit $35 a month
Family: $7,500 injury benefit $41 a month
Family: $10,000 injury benefit $47 a month

When it come to families and emergency room insurance supplements it’s almost a no brainer. Family monthly member price is the same for a married couple with 1 child or 10 kids. Bigger the family, the more this plan will pay out. Children can stay on family plan up until age 26. Age 26 and up dependents will need to roll off onto a individual plan. The industries leading ER plans cover kids sport league injuries for Soccer, Baseball, Football, and other high school sports. Just like any other health insurance policy, these plans only cover bodily injury claims if policy was in force prior to injury.

Specific Benefits Covered with emergency room insurance supplements:

Hospital Emergency Room.

Surgeon fees for surgery.

Ambulance Charge.

Operating Room costs.

Lab tests.


Doctors visits (inpatient and outpatient).

Hospital room and board, and general nursing care.

Hospital miscellaneous expense during confinement, outpatient surgical procedures.

X-Rays and MRI’S.

Prescription drugs.

Dental treatment for injured sound natural teeth.

Registered nurse charges.