Guides / Accident and critical illness
Accident and critical illness plans.
These are limited policies. Neither one is health insurance. Neither one replaces a medical plan. Whether you need one, and for how much, is a conversation with Seth.
How do accident and critical illness plans pay?
An accident plan pays for a covered accident. A critical illness plan pays you a lump sum for a covered diagnosis. Neither one replaces a medical plan.
Accident
An accident plan pays when you are hurt in a covered accident. A fall, a broken bone, stitches, or an emergency room visit are the kinds of events people ask about. The policy decides which events count.
The plan pays toward accident costs up to a set amount, or it pays fixed amounts for covered treatments. These plans typically pay in addition to a medical plan. You can use the payment on the remaining bill. They are not coordinated the way two medical plans might be. Confirm that in the brochure.
Critical illness
A critical illness plan pays you a lump sum if you are diagnosed with a covered condition. Which conditions count, such as certain cancers, a heart attack, or a stroke, is in the brochure. This page does not list them.
The money is paid to you. People use it for medical bills, rent, or time away from work. The premium is usually based on age at purchase. Whether it can change later is in the policy.
What they do not do
- They are not health insurance and they are not a substitute for a medical plan.
- Each policy has its own exclusions, waiting periods, and pre-existing limits.
- A claim needs documents, often an itemized bill. Describe what happened the way it happened.
- Accident treatment often has a time window. The brochure lists it. This page does not state a number of days.
- They generally do not cover maternity, mental health, substance use treatment, or pediatric dental. Those are medical-plan questions.
Accident example. An emergency room visit after a fall is billed at $2,200. In this made-up case the accident policy pays $1,500. That payment can be used on what is left. Nothing here says a real policy would pay $1,500.
Critical illness example. A covered diagnosis pays a $20,000 lump sum to you. That number is invented. It is not a list of covered conditions and it is not a benefit you have been offered.
Tell Seth if you want either policy included when he prepares options. Do not send medical details through this website.
Related: fixed indemnity, private PPO, and common questions.
Accident plan name and brochure
Critical illness plan name and brochure
Questions about your own coverage go to Seth. This page cannot answer them.