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An employee is cleaning their gutters when the ladder slips and they fall off.
The physician visit and x-ray in the ER reveals a dislocated hip and a broken wrist.
Cash benefits are paid directly to the policyholder (unless assigned otherwise), helping ease the financial stress of their accident.
Claims made on their Aflac Accident Indemnity Advantage® 1 policy are paid fast, so unexpected bills don't have to leave them sidelined.
The average cost of a broken leg is $7,274.2
After major medical coverage, they could still owe $2,910 in out-of-pocket medical expenses not covered by their insurance.3
Get a Quote| Medical Expenses | $7,274 | |
| Avg. Insurance Coverage | 60% | |
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| Remaining Expenses* | $2,910 | |
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| Aflac Supplemental Coverage: | ||
| Accident | up to $0 | |
| Hospital | up to $0 |
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| Aflac pays the policyholder: | $0 | |
and affordable weekly rates as low as one box of adhesive bandages.4
Companies choose to make Aflac policies available to increase benefits options without impacting their bottom line.
*The information provided in the Benefits Estimator is illustrative only. Plans may not be available in all states, and benefits may vary by state, coverage, and plan level selected. Policies have limitations and exclusions that may affect benefits payable. The Aflac payout values do not guarantee an amount to be paid for the listed conditions. Benefits paid by Aflac (if any) will depend on the severity of the accident or illness, the physician diagnosis, and the treatment received. The “Aflac Pays You” data is an average of historical payments made to Aflac policyholders/certificateholders who qualified for benefits under their specific plans and does not reflect instances when benefits were not paid for a particular claim. Whether benefits are payable will be determined when a claim is processed. You must be 18 or older to apply for Aflac insurance. Availability varies by product; see your local Aflac agent for details. The out-of-pocket expenses displayed are estimated at 40% of the total medical cost, assuming that average major medical plans cover approximately 60% of the expense. Your major medical coverage may be more or less, and if an individual or family incurs expenses for non-covered benefits, these out-of-pocket expenses may increase potential unexpected costs. You will also need to pay for any limits or exclusions on your benefits which may include the number of refills for certain drugs, visits to certain specialists, or days covered for certain benefits. View Data Sources to see our underlying sources for the data provided in this calculator.
1 ACCIDENT – A36000 series
In Arkansas, Policies A36100AR–A36400AR, & A363OFAR. In Idaho, Policies A36100ID–A36400ID, & A363OFID. In Oklahoma, Policies A36100OK– A36400OK, & A363OFOK. In Oregon, Policies A36100OR–A36400OR, & A363OFOR. In Pennsylvania, Policies A36100PA-A36400PA. In Texas, Policies A36100TX–A36400TX, & A363OFTX. This is a brief product overview only. Coverage may not be available in all states including but not limited to Virginia. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. The policy has limitations and exclusions that may affect benefits payable. Refer to the policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Aflac agent.
Limitations and Exclusions for residents of Arizona:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force.
Aflac will not pay benefits for treatment or loss due to Sickness including:
Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
Limitations and Exclusions for residents of Idaho:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
Limitations and Exclusions for residents of New Jersey:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
2 Broken Leg Diagnosis & Treatment, Mayo Clinic, July 01, 2020.
https://www.mayoclinic.org/diseases-conditions/broken-leg/diagnosis-treatment/drc-20370416.
Costs of diagnosis and treatment(s) are based on:
Transport - Ambulance Ride(1): $366.00
Source: http://cost-finder.com/what-is-the-cost-of-ambulance-transport/.
ER - ER Visit (1): $1,389.00
Source: https://www.debt.org/medical/emergency-room-urgent-care-costs/.
Diagnostic - X-Ray (1): $240.00
Source: https://www.newchoicehealth.com/procedures/leg-x-ray.
Treatment - Open reduction surgery (1): $3,655.00
Source: https://www.alliedacademies.org/articles/the-cost-of-quality-open-reduction-and-internal-fixation-techniques-versus-percutaneous-kwire-fixation-in-the-management-of-extraa.html.
Post-Treatment - Walking cast (1): $226.00
Source: https://www.healthcarebluebook.com/ui/proceduredetails?cftId=345&directsearch=true.
Post-Treatment - Crutches (1 set): $228.00
Source: https://health.costhelper.com/crutches.html.
Wellness Maintenance - Doctor Visit (3): $645.00
Source: https://www.healthcarebluebook.com/ui/proceduredetails/225?directsearch=true&tab=ShopForCare.
Wellness Maintenance - Physical Therapy (7 visits): $525.00
Source: https://thervo.com/costs/physical-therapy-cost.
Total Cost: $7,274.00
3 The information provided in the Benefits Estimator is illustrative only. Plans may not be available in all states, and benefits may vary by state, coverage, and plan level selected. Policies have limitations and exclusions that may affect benefits payable. The Aflac payout values do not guarantee an amount to be paid for the listed conditions. Benefits paid by Aflac (if any) will depend on the severity of the accident or illness, the physician diagnosis, and the treatment received. The “Aflac Pays You” data is an average of historical payments made to Aflac policyholders/certificateholders who qualified for benefits under their specific plans and does not reflect instances when benefits were not paid for a particular claim. Whether benefits are payable will be determined when a claim is processed. You must be 18 or older to apply for Aflac insurance. Availability varies by product; see your local Aflac agent for details. The out-of-pocket expenses displayed are estimated at 40% of the total medical cost, assuming that average major medical plans cover approximately 60% of the expense. Your major medical coverage may be more or less, and if an individual or family incurs expenses for non-covered benefits, these out-of-pocket expenses may increase potential unexpected costs. You will also need to pay for any limits or exclusions on your benefits which may include the number of refills for certain drugs, visits to certain specialists, or days covered for certain benefits. View Data Sources to see our underlying sources.
4Assumes the average cost of a package of adhesive bandages is $5**. Comparison is based on the average weekly premium for Nebraska Payroll Premium rates for industry Class B, Accident Advantage - Option 2 - Series A36200; Individual Age 18-70. Premiums may vary by coverage type, account, state of issue, and the election of additional/optional benefits.
**Source: cvs.com, 2020.
