Home Emergency Medical Protection


If you are injured in your home and need to go to the emergency room within 48 hours for treatment, this will reimburse you up to $5,000.  When an unexpected accident occurs in the home, this benefit assures you stay protected and keeps more money in your pocket.

  • Provides protection in the event emergency room treatment is required as a result of an accident that occurs in the home.  Benefit will pay up to $5,000 per occurrence, per year.


Definition:  “You or “Your” means the enrolled Member.  The term “You” or “Your” shall also include each Family Member.  Family Member means the Member’s spouse and all unmarried children under 21 years of age (or less than 23 years of age if a full-time student at an accredited college or university), who have the same principal residence as the Member.

The home emergency medical expense reimbursement benefit is payable if the Member requires emergency treatment in an Out-patient Facility as a result of an injury due to a home accident.  The emergency treatment must be received within forty-eight (48) hours of the home accident which caused the injury.  The benefit will pay up to $5,000 per occurrence, per year, for the emergency treatment expenses actually incurred by the Member during the forty-eight (48) hour period immediately following the time emergency treatment was first received and that are not covered by any other insurance available to the Member.


  • Home accident means an accident which occurs while the Member is inside or on the premises of his/her primary residence.
  • Emergency treatment expenses means out-patient facility charges for:
    • diagnosis, treatment or surgery performed by a physician, surgeon or dentist;
    • laboratory tests and X-ray examinations, if such tests or examinations are made by, or at the request of, the physician, surgeon or dentist;
    • casts, splints and medication, and
    • any other reasonable and necessary emergency services and supplies.
  • In no event, however, will emergency treatment expenses include any In-patient charges or any out-patient facility charges, which exceed the usual and customary charges for comparable diagnosis, treatment, surgery, tests, examinations, cast, splints, medication, services and supplies.
  • To submit a valid claim, Membership must be in effect when accident occurs.


  • Suicide or self-destruction, or any attempt thereat, while sane or insane;
  • Declared or undeclared war, or any act thereof;
  • Bacterial infection, except pus-forming infections resulting from Injury;
  • Participating in or attempting to commit a felony;
  • Illness, disease or allergic reaction;
  • Ingestion of a poisonous substance (except that accidental ingestion of a poisonous substance  which causes Injury is not excluded);
  • Being under the influence of narcotics, unless taken in accordance with the advice of a physician;
  • Any inpatient charges;
  • Any loss caused by illegal activities inside the home or on the premises;
  • Being under the influence of alcohol.
This summary is a brief overview of the program and is not to be considered a full disclosure of policy terms. Please refer to the Terms and Conditions for complete forms, conditions, limitations, definitions, and exclusions.

How To File a Claim

How to file a claim:

In the event a home accident occurs and the Member seeks reimbursement for the benefits above, he/she should call 1-800-711-4280 to request a Claim form.

Once the Claim form is received by the Member, it should be completed and mailed back to the address shown at the bottom of the Claim form with the following documentation:

  • Copy of the Member’s primary Homeowners insurance policy.
  • Copy of in-patient medical bills explaining treatment received.
  • Any other documentation requested by Claim Administrator.