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Supplemental Health

Accident Medical Expense

Accidents happen when you least expect them, but you shouldn't have to worry about the medical bills.

Benefit Amounts

$2,500 – $10,000

Deductible Options

$100 / $250

Available

29 States

Underwritten By

Arch Insurance

About This Program

As part of an individual supplemental health plan, accident medical expense reimbursement insurance may help to cover unexpected out of pocket medical expenses in the event of an accident resulting in injury.

Unlike fixed accident scheduled indemnity plans, which pay a predetermined amount based on the specific injury or service, accident medical expense reimbursement insurance covers actual medical expenses incurred up to the purchased plan limit.

Covered expenses are reimbursed at 80% of actual billed charges, after your deductible and up to the benefit amount you choose. To be eligible, you must first incur expenses for treatment within seven days of the accident, and expenses are payable for 52 weeks from the accident date.

This is supplemental coverage. This insurance is not an alternative or replacement to comprehensive medical or major medical coverage. The policy is a short-term policy, with limited benefits.

Why It Matters

01

Out-of-Pocket Costs

Medical expenses such as co-pays, deductibles, and out-of-network expenses can take you by surprise. This coverage is designed to help cover out-of-pocket costs such as deductibles, copays, and other expenses after an injury.

02

Actual Expenses, Not a Fixed Payout

Fixed indemnity plans pay a predetermined amount based on the specific injury or service. This coverage reimburses actual medical expenses incurred, up to the purchased plan limit.

03

Works With Your Major Medical

The benefit payable for Accident Medical Expenses is designed to supplement your major medical plan. It is payable on an excess basis after any insurance available for the same covered loss.

04

Built for the Unexpected

Whether it's a broken bone or a trip to the ER, this plan can help cover out of pocket expenses arising from the unexpected. Stay prepared with affordable accidental injury protection.

Available Benefits

Medical expenses not covered by major medical following an accident

Emergency room visits
Doctor's appointments
Hospital stays
Ambulance services
Surgeries
Other related medical treatments

Why You Need This

Real situations where accident medical expense coverage does the work

A Trip to the ER After a Fall

You break a bone on a weekend and end up in the emergency room. Your major medical plan handles part of it, but you are still facing a deductible and copays. This coverage is designed to help reimburse those out-of-pocket costs.

Covered expenses: Hospital room and board and Hospital care · Medical care and treatment by a Physician

An Ambulance Ride You Didn't Plan For

Emergency transportation is one of the costs people are most often surprised by after an accident, and it is frequently billed outside your network. Transportation in an emergency transportation vehicle is a covered medical expense under this plan.

Covered expenses: Transportation in an emergency transportation vehicle

Imaging and Follow-Up Care

An injury rarely ends with one visit. X-rays, diagnostic tests, prescriptions, and follow-up appointments add up over the weeks that follow. Those expenses may be reimbursed at 80% of billed charges, up to your purchased plan limit.

Covered expenses: Diagnostic tests and x-rays · Drugs and medicines prescribed by a Physician

Rehab After a Serious Injury

Getting back to normal can mean weeks of physical therapy, a brace, or rented medical equipment. These are among the covered medical expenses under an accident medical expense plan.

Covered expenses: Physical therapy · Orthopedic appliances or braces · Rental of durable medical equipment

Covered Medical Expenses

Covered medical expenses include treatment, service or supply that is required to treat an Accidental Bodily Injury, and prescribed or ordered by a Physician or furnished by a hospital, including but not limited to:

Medical care and treatment by a Physician
Treatment performed by a licensed medical professional when prescribed by a Physician, if hospitalization would have been otherwise required
Hospital room and board and Hospital care, both inpatient and outpatient
Dental care and treatment due to Accidental Bodily Injury
Drugs and medicines required and prescribed by a Physician
Physical therapy, including diathermy, ultrasonic, whirlpool or heat treatment
Diagnostic tests and x-rays prescribed by a Physician
Rental of durable medical equipment
Transportation in an emergency transportation vehicle from where the injury occurs to the nearest hospital
Artificial limbs and other prosthetic devices
Orthopedic appliances or braces

Plan Highlights

Available Benefit Amounts

$2,500 · $5,000 · $7,500 · $10,000

Available Deductible Options

$100 · $250

Reimbursement

80% of billed charges

Treatment Window

Within 7 days

Coverage Ends

Age 65

Rates

Vary by state and age

What's Not Covered

This is a summary. The policy contains the full list of exclusions and limitations.

Pre-existing conditions
Injuries sustained while on the job in certain industries, including construction trades, trucking, agriculture, and delivery or rideshare platform driving
Chronic conditions not resulting from an accident, such as arthritis, tendinitis, bursitis, carpal tunnel syndrome, plantar fasciitis, and stress fractures
Illness, disease, and infection, including medical or surgical treatment of them
Repetitive motion injuries and cumulative trauma
Expenses covered by Workers' Compensation or similar occupational benefits
Extreme sports and hazardous activities, including rock climbing, whitewater rafting, motocross, skydiving, and scuba diving below 25 feet
Chiropractic care, acupuncture, and massage therapy
Accidents involving intoxication or controlled substances not prescribed by a Physician
Eyeglasses, contact lenses, hearing aids, and routine physical exams
Professional and NCAA collegiate sporting activity
Treatment obtained outside the United States or its territories

Frequently Asked Questions

What is Accident Medical Expense coverage?

Unlike fixed accident scheduled indemnity plans, which pay a predetermined amount based on the specific injury or service, accident medical expense reimbursement insurance covers actual medical expenses incurred up to the purchased plan limit.

How does this work with my existing health insurance?

The benefit payable for Accident Medical Expenses is designed to supplement your major medical plan. As such, it is payable on an excess basis after any insurance available to the Covered Person for the same Covered Loss.

What does it mean that benefits are paid on an "excess basis"?

It means this plan pays second, not first. After an injury, your major medical plan pays its share of the bills. What's left over — your deductible, copays, and other out-of-pocket amounts — is what this plan looks at. It then reimburses those remaining costs, after your $100 or $250 deductible, up to the benefit amount you purchased. This is what allows the coverage to stay affordable: it is designed to fill the gap your main health plan leaves behind rather than duplicate it.

Is this a replacement for major medical insurance?

No. This insurance is not an alternative or replacement to comprehensive medical or major medical coverage. The policy is a short-term policy, with limited benefits.

What benefit amounts and deductibles can I choose?

Available benefit amounts are $2,500, $5,000, $7,500, and $10,000. Available deductible options are $100 and $250.

How much of my bill is reimbursed?

Covered expenses are reimbursed at 80% of actual billed charges, after your deductible and up to the benefit amount you purchased. Charges must be reasonable and customary.

How soon do I need to see a doctor after an accident?

Within seven days. You must first incur expenses for care and treatment of the injury within seven days of the accident for the benefit to apply. After that, expenses are payable for 52 weeks from the date of the accident. If you're hurt, get seen promptly — waiting it out can cost you the claim.

What if I don't have health insurance?

You can still be covered. The plan pays on an excess basis after any other insurance available for the same loss — but if there is no other coverage, there is nothing for it to sit behind, and the benefit responds after your deductible. Note that other payment sources count too, not just health insurance: auto insurance, workers' compensation, and disability coverage all pay before this plan does.

Is there an age limit?

Coverage ends when the policyholder reaches age 65. All covered persons must be U.S. residents and maintain a primary residence in the United States.

Does it cover injuries that happen while I'm working?

Not in every occupation. The policy excludes injuries sustained while on the job in certain industries, including construction trades, trucking, agriculture, and delivery or rideshare platform driving. This applies whether you are an employee, an independent contractor, or self-employed. Expenses covered by Workers' Compensation are also excluded. Check the full exclusions in the policy before you buy.

What medical expenses are covered?

Covered medical expenses include treatment, service or supply that is required to treat an Accidental Bodily Injury and prescribed or ordered by a Physician or furnished by a hospital. This includes, but is not limited to, physician care, hospital care, prescriptions, diagnostic tests and x-rays, emergency transportation, dental care due to Accidental Bodily Injury, physical therapy, durable medical equipment rental, prosthetic devices, and orthopedic appliances or braces.

How much does it cost?

Rates vary by state and age. Request a quote and our team will follow up with pricing for your situation.

Stay prepared with affordable accidental injury protection.

Notice: This is a brief description of coverage provided and is subject to the terms, conditions, limitations and exclusions of the policy. Coverage may vary or may not be available in all jurisdictions. The policy is a short-term policy, with limited benefits. This insurance is not an alternative or replacement to comprehensive medical or major medical coverage. Benefits are reimbursed at 80% of actual billed charges for reasonable and customary medical expenses, subject to your deductible and benefit amount. Expenses must be first incurred within seven days of the accident and are payable for 52 weeks from the accident date. Coverage terminates when the policyholder reaches age 65. All covered persons must be U.S. residents maintaining a primary residence in the United States. The "What's Not Covered" summary above is not a complete list of exclusions; please refer to the policy for full details. Accident Medical Expense coverage is underwritten by Arch Insurance Company (NAIC #11150).

Disclaimer: This product is offered subject to availability, carrier underwriting guidelines, eligibility, state of residence, and applicable regulatory approvals. Coverage, limits, premiums, and features may vary by carrier and may change without notice. Quotes shown are estimates and not a guarantee of coverage or final pricing. Final terms are determined by the issuing insurance carrier and outlined in the policy documents. Olli is a licensed insurance producer and not the underwriter of these products.