Accident Insurance

Accident insurance provides a lump sum payment to help pay for expenses that medical insurance may not cover if you are injured in an accident.

Accidents can happen when you least expect them. Help make your recovery less expensive and stressful with MetLife Accident Insurance.

What is Accident Insurance?

Accident insurance provides a financial cushion for life’s unexpected events. You can use it to help pay costs that aren’t covered by your medical plan. As a reminder, you must have medical coverage to be eligible for this benefit. It provides you with a lump-sum payment –one convenient payment all at once–when you need it most. The extra cash can help you focus on getting back on track, without worrying about finding money to help cover the costs of treatment.

Accidents happen every 2 seconds at home and every 7 seconds on the road.¹And accidents can be expensive; each trip to the emergency room costs an average of $1,233.²Expenses can add up quickly.

Protect your family’s budget by enrolling for MetLife Accident Insurance today. Here’s why:

You get broad coverage
More than 150 events and services, such as fractures, 2nd & 3rd degree burns, and treatments resulting from an accident are covered.
Payments are made directly to you when you have covered medical services/treatments as the result of an accident occurring outside of work.
You decide how to spend the money: Pay for medical expenses not covered by your plan, like copays or deductibles, or for non-medical needs like household bills, childcare, or home modifications.
You won't be denied coverage
You and your eligible family members are guaranteed coverage, as long as you are actively at work.³ That means no medical exam and no hassle.
Additional benefits for Health Screening Benefits
You and your eligible family members may receive an annual reimbursement for included Health Screening Benefits.
It’s less expensive than you may think.
Take advantage of caregiver rates when applying for coverage through your employer.

This plan provides protection for covered events experienced while off the job only.

Here's how it works:

Kathy’s daughter, Molly, plays soccer. During a recent game, Molly collided with an opposing player, was knocked unconscious and taken to the local emergency room (ER) by ambulance for treatment. The ER doctor diagnosed a concussion and a broken tooth. He also ordered a CT scan. After thorough evaluation, Molly was released to her primary care physician for follow-up treatment, and her dentist repaired her broken tooth with a crown. Luckily Kathy has accident insurance!

Coverages2	Benefit Amount3
Ambulance (ground)	$300
Emergency Care	$100
Medical Testing	$200
Concussion	$400
Physician Follow-Up ($75x 2)	$150
BrokenTooth (repaired by crown)	$200
Kathy would get a lump-sum payment totaling $1,350 with MetLife Accident Insurance High Plan.

This example is for illustrative purposes only.
Benefits paid by MetLife Accident Insurance High Plan

What is covered?

Here are some of the more utilized covered events/services:

MetLife Accident Insurance Pays YOU
Benefit Type²	Basic Plan	Enhanced Plan
Injuries
Fractures^1- Closed	$50 - $2,000	$100 - $3,000
Fractures¹-Open	$100 - $4,000	$200 - $6,000
Dislocations¹–Closed	$50 - $2,000	$100 - $3,000
Dislocations¹–Open	$100 - $4,000	$200 - $6,000
Second and Third Degree Burns–1x per accident	$50 - $5,000	$100 - $10,000
Concussions–1x per year	$200	$400
Cuts/Lacerations – 1x per accident / 3x per year	$25 - $200	$50 - $400
Eye Injuries – 1x per accident / 3x per year	$200	$400
Broken Tooth Benefit – 1x per accident / 3x per year	$25 - $100	$50 - $200
Medical Services & Treatment
Ambulance – 1x per accident / per year	$300 Ground, $750 Air	$400 Ground, $1,000 Air
Emergency Care – 1x per accident	$50 - $120	$75 - $180
Physician Follow-up – 2x per accident / 6x per year	$50	$75
Therapy Services (including physical therapy) – 10x per accident / 15x per year	$15	$25
Medical Testing Benefit –X-ray, CT, CAT, MRI, EEG, Ultrasound, NCV – 1x per accident / 2x per year	$100	$200
Prosthetic Device Benefit – 1x per accident	$500 - $1,000	$750 - $1,000
Medical Appliances	$50 - $250	$100 - $1,000
Inpatient Surgery – 1x per accident / 2x per year	$100 - $1,000	$200 - $2,000
Outpatient Ambulatory Surgery – 1x per accident / 2x per year	$150	$300
Hospital⁵ Coverage (Accident)
Admission – 1x per accident	$500	$1,000
ICU Supplemental Admission (paid in addition to Admission) – 1x per accident	$500	$1,000
Confinement (non-ICU confinement paid for up to 31 days, starting day 1).	$100	$200
ICU Supplemental Confinement (paid in addition to confinement, 31 days)	$100	$200
Coma – 1x per accident	$5,000	$10,000
Other Benefits
Lodging⁶ – Pays for lodging for companion up to 30 nights per calendar year	$100	$200
Health Screening Benefit – 1x per year	$50	$50

The example below illustrates a caregiver who elected the low Accident plan, with Family coverage.

Kathy’s daughter, Molly, plays soccer on the high school team. During a game, she collided with an opposing player, was knocked unconscious and taken to the local emergency room by ambulance for treatment. The ER doctor diagnosed a concussion and a broken tooth.He ordered a CT scan to check for facial fractures too, since Molly’s face was very swollen. Molly was released to her primary care physician for follow-up treatment, and her dentist repaired her broken tooth with a crown. Depending on her health insurance, Kathy’s out-of-pocket costs could run into hundreds of dollars to cover expenses like insurance co-payments and deductibles. MetLife Group Accident Insurance payments can be used to help cover these unexpected costs.

Covered Event²	Basic Plan – Benefit Amount⁷
Ambulance (ground)	$300
Emergency Care	$120
Physician Follow-up ($50 x 2)	$100
Medical Testing	$100
Concussion	$200
Broken Tooth (repaired by crown)	$100
Benefits paid by MetLife Group Accident Insurance	$920

Type	Basic	Enhanced
Caregiver Only	$4.84	$7.85
Caregiver + Spouse/Domestic Partner	$9.68	$15.68
Caregiver + Children	$11.42	$18.50
Caregiver + Family	$13.64	$22.10

Protection for Everyday Life

MetLife Accident Insurance covers over 150 events and services such as physical therapy, fractures, disclocations, and medical treatments or tests resulting from an accident.

Lump Sum Hassle-free Payments to You

You'll receive a lump-sum payment for covered medical services such as ambulance costs and emergency care to protect yourself and your budget.

Flexilbility

one convenient payment provides you with a financial cushion to use how you want. Help pay for everyday expenses like grocery bills and childcare expenses.

¹ National Safety Council Injury Facts, 2015 Edition. Itasca, IL (based deaths and medically consulted injuries by class, 2013).

² “Outrageous E.R. Hospital Charges: What to Do,” FoxBusiness.com. June 27, 2013.

³ Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage.Additional restrictions apply to dependents serving in the armed forces or living overseas.

⁴ Chip fractures are paid at 25% of Fracture Benefit and partial dislocations are paid at 25% of Dislocation Benefit.

⁵ Covered services/treatments must be the result of a covered accident as defined in the group policy/certificate.
See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.

⁶ Eligibility for portability through the Continuation of Insurance with Premium Payment Provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.

METLIFE'S ACCIDENT INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage.The policy or its provisions may vary or be unavailable in some states.There is a preexisting condition limitation for hospital sickness benefits, if applicable. MetLife’s Accident Insurance may be subject to benefit reductions that begin at age 65. And, Like most group accident and health insurance policies, polices offered by MetLife may contain certain exclusions, limitations and terms for keeping them in force.For complete details of coverage and availability, please refer to the group policy form GPNP16-AX or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.

Accident Insurance