Accident insurance: what it covers and when it is worth having.

What accident insurance pays for.

Policies list a schedule of benefits. Typical items include:

• Emergency room and urgent care visits for an injury
• Ambulance
• Fractures and dislocations, often scaled by the bone or joint
• Lacerations, burns and concussions
• Follow-up visits, physical therapy and medical equipment
• Hospital admission after an accident
• Accidental death and dismemberment, in many policies

You receive the scheduled amount regardless of what your health plan pays. Some policies cover accidents on and off the job; others cover off-the-job only, assuming workers' compensation covers work injuries.

Who it fits.

• Families with kids in sports.
• People with physical jobs or hobbies.
• Anyone with a deductible they could not easily pay after an injury.

If you rarely get hurt and have savings that cover your deductible, the premium may be better spent on a higher metal level.

What to check.

• Whether it covers on and off the job.
• Which injuries are on the schedule, and the amounts.
• Whether benefits reduce at older ages.
• Whether sports or certain activities are excluded.
• Portability if you leave an employer-sponsored version.

Supplemental policies are limited-benefit insurance. They pay a fixed cash amount when a covered event happens and are designed to sit alongside major medical coverage, not replace it. They do not count as minimum essential coverage, are not sold on HealthCare.gov, and cannot be paid for with a premium tax credit.

Questions people ask.

Sources.

1. Texas Department of Insurance, Limited-benefit and supplemental health insurance. tdi.texas.gov
2. Texas Department of Insurance, Alternative health plans and supplemental coverage. tdi.texas.gov
3. 45 CFR 146.145, Excepted benefits (hospital indemnity, specified disease, accident). ecfr.gov
4. 26 CFR 1.5000A-2, Minimum essential coverage (excepted benefits are not MEC). ecfr.gov

General information for Texas and Oklahoma residents, not tax or legal advice. Rules and numbers can change; this page is reviewed on the date shown above. Your eligibility and prices are set by HealthCare.gov or the insurer when you apply.