Accident, Sickness & Hospital

Accident, Sickness and Hospital plans allow you to direct your own health care and visit almost any doctor or hospital you like. The insurance company then pays a set portion of your total charges.

What is Accident, Sickness & Hospital Insurance?

Accident, Sickness and Hospital plans allow you to direct your own health care and visit almost any doctor or hospital you like. The insurance company then pays a set portion of your total charges. Accident, Sickness and Hospital plans are also referred to as "fee-for-service" plans. A very common substitute for health coverage that guarantees your acceptance and can get your coverage started immediately.

How does an Accident, Sickness & Hospital plan work?

Under an Accident, Sickness and Hospital plan, you may see whatever doctors or specialists you like, with no referrals required. Though you may choose to get the majority of your basic care from a single doctor, your insurance company will not require you to choose a primary care physician. An Accident, Sickness and Hospital plan may also require that you pay up front for services and then submit a claim to the insurance company for reimbursement. Many Accident, Sickness and Hospital plans give you benefits outright, meaning that coverage starts on the first dollar of your first claim submission, effectively helping you get coverage at your doctors, hospitals, and medical facilities, starting immediately upon your plan going into effect.

Rarely will you be required to pay an annual deductible before the insurance company begins to pay on your claims, but this may occur in some instances. However, once your deductible has been met for that medical service, the insurance company will typically pay your claims at a set percentage of the "usual, customary and reasonable (UCR) rate" for the service. The UCR rate is the amount that healthcare providers in your area typically charge for any given service.

An Accident, Sickness and Hospital plan may be right for you if:

  • You're looking for the greatest level of freedom possible in choosing which doctors or hospitals to visit
  • You don't want to designate primary care physicians or get referrals to specialists
  • You want to freely visit any physician you choose
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