Sickness and accident insurance

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Accident and sickness insurance can help you stay financially secure if an unexpected setback leaves you with medical bills and rehabilitation costs. But it’s not as comprehensive as other insurance types.

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What is accident and sickness insurance?

Accident and sickness insurance policies can offer peace of mind when illness or injury strikes a policyholder unexpectedly. These types of supplemental insurance can help offset out-of-pocket costs and ease the financial burden that may come with any additional medical or daily expenses.

An accident and sickness policy combines accident insurance, which pays out a lump sum after you’re injured in an accident, with critical illness insurance, which pays out a lump sum after you’re diagnosed with a covered illness. How much it pays out will depend on what injury you have. Serious injuries and illnesses that require more medical care will generally result in a higher benefit payout to help offset the cost.

What’s covered in this type of policy?

Coverage varies based on insurer and plan type, but an accident and sickness policy will often include events such as:

  • Emergency room visits
  • Ambulance rides
  • Urgent care visits
  • Broken or fractured bones
  • Burns
  • Concussions
  • Cancer diagnoses
  • Strokes

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What’s the maximum age of eligibility?

The maximum age that you can take out critical illness and accident insurance varies between insurance providers. However, as a general rule, people aged from 18 to 75 years of age are typically able to apply for coverage.

Most sickness and accident insurance policies will also stop providing coverage once you reach a certain age, usually 90+. Check the terms and conditions of the policy to learn more about the eligibility requirements.

Does accident and sickness insurance cover death?

It depends on your policy. Most accident insurance is intended to help cover survivable injuries, like broken bones and concussions. It’s different from accidental death and dismemberment (AD&D) insurance, which pays out a benefit if you die in an accident or are seriously injured.

But in many cases, accident insurance and AD&D insurance can be bundled together into one policy that protects you from accidents of any severity.

How can this coverage protect me financially?

Accident and sickness insurance can be used to help pay for:

  • Medical expenses. Offset the cost of emergency room visits, ambulance or helicopter transportation, exams or treatments and any other expenses that may arise relating to your recovery.
  • Home health service. Insurance can help cover the costs of hiring an at-home nurse.
  • Rehabilitation. Helps cover the expenses of an approved rehabilitation program.
  • Rehabilitation expenses. Pays for various expenses that may arise during recovery, including home modifications relating to the injury or illness.
  • Everyday expenses. If an accident or illness leave you temporarily unable to work, your payout can be used to help with day-to-day expenses.

Is my sickness and accident insurance policy tax deductible?

No, premiums are generally not tax deductible because the benefit is paid untaxed.

What are the drawbacks?

Personal accident and critical illness insurance should be viewed as a basic type of coverage with a limited range of protection. Here’s why:

  • Waiting periods. Some policies have a waiting period of 60 days before the insurance effectively kicks in. That means if you’re injured or fall ill in that brief period of time, you would likely not be eligible to receive a benefit.
  • Limited coverage. Some critical illness policies won’t cover any pre-existing medical conditions — and if they do, you’ll likely have a much higher premium due to your circumstances.
  • Different benefit periods. Personal sickness and accident insurance will have a defined waiting and benefit period for various situations.

Accident insurance vs. disability insurance

Personal accident insurance and critical illness insurance both play out a lump sum if you’re injured or diagnosed with a covered illness. Disability insurance pays out a percentage of your income until you’re able to return to work.

Accident and sickness insurance is more helpful for immediate upfront costs, like adding a wheelchair ramp to your home, paying for rehabilitation or supplementing health insurance. Disability insurance is intended to help with day-to-day expenses in the long term.

Is accident and sickness insurance right for me?

Accident and sickness insurance is particularly useful for people who don’t have a large savings account built up. If a trip to the ER or a few days of missed work could land you in financial trouble, this type of policy might be a good idea for you.

How much does it cost?

The cost of a policy can vary greatly depending on how much coverage you have. Rates range from $5 a month for standalone accident insurance without coverage for illnesses to $150 a month or more for comprehensive plans.

Bottom line

Critical illness and accident insurance can be the right option for someone looking for a basic level of coverage at an affordable price, but it works best as a supplement to life insurance — not as a replacement. As always, be sure to compare life insurance providers so you can make a fully informed decision when finding the policy that meets your needs.

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