What Does Walmart Accident Insurance Cover: Benefits and Claims

Walmart’s voluntary accident insurance pays set cash amounts directly to you when you’re hurt in an accident that happens off the job. It’s a supplement to your medical plan, not a replacement, and the money can go toward deductibles, copays, lost pay, or anything else. Each covered injury or treatment has its own dollar figure, and several can pay out from a single accident.¹

The plan is underwritten by American Heritage Life Insurance Company and administered by The Standard, with 2026 coverage effective January 1.

How Benefits Stack From One Accident

Benefits are itemized, not pooled. A broken leg that sends you to the emergency room by ambulance, requires surgery, and then physical therapy can trigger a separate payment for each of those pieces. The amounts below come from the 2026 benefit schedule.

Hospital, Emergency Room, and Ambulance Benefits

Initial hospitalization: $1,500 per year for a stay of at least 24 hours, or $2,250 if you’re admitted directly to intensive care.
Hospital confinement: $300 per day for up to 365 days, for stays of at least 18 hours.
ICU confinement: $900 per day, up to 15 days.
Step-down ICU: $200 per day, up to 15 days.
Immediate care treatment: $170 per accident for physician fees, X-rays, or ER services.
Ground ambulance: $400. Air ambulance: $4,000. Transport must happen within 72 hours of the accident and be provided by a licensed ambulance company.²

Payouts for Specific Injuries

The plan assigns a dollar amount to each kind of injury based on type and severity.³

Fractures: $375 for a coccyx or toe up to $3,750 for a hip. Chip fractures and other minor fractures pay 25% of the listed amount.
Dislocations: $188 for a toe or finger up to $3,750 for a hip. Knee and shoulder dislocations pay $938.
Second-degree burns: $100 to $1,000 depending on body surface area. Third-degree burns: $200 to $10,000.
Lacerations: $25 for cuts not needing sutures, up to $400 for cuts longer than 15 centimeters.
Coma lasting at least seven days: $10,000. Medically induced comas are not covered.
Brain concussion: $50.
Eye injury: $250 for surgical repair, $50 for foreign body removal.
Emergency dental: $150 for a crown, $50 for an extraction.

Surgery Benefits

Open abdominal, cranial, hernia, or thoracic surgery: $1,400.
Ruptured disc, torn ligament or tendon, torn knee cartilage, or torn rotator cuff repair: $700.
Arthroscopy without repair or miscellaneous surgery: $350.
Skin grafts: 50% of the applicable burns benefit.

Follow-Up Care, Equipment, and Travel

Care after the initial accident is covered on its own schedule.³

Follow-up treatment: $50 per visit, up to six visits. Treatment has to start within 30 days of the accident or hospital discharge.
Physical therapy: $50 per day, up to 10 days per accident, physician-prescribed and received within six months. You can’t claim both the follow-up and physical therapy benefit for the same accident.
Rehabilitation unit confinement: $100 per day, up to 30 days per stay and 60 days per year, for inpatient rehab after a hospital stay.
Major diagnostic exams (CT, MRI, EEG): $400 per year.
Prosthetic devices: $1,000, paid once per accident. Hearing aids, wigs, and dental aids don’t qualify.
Medical appliances: $200 for crutches, wheelchairs, leg braces, CAM boot walkers, back braces, or walkers when prescribed by a physician.
Blood, plasma, or platelets: $100.
PTSD counseling: $100 per day, up to six days per year.

If treatment requires travel to a hospital more than 100 miles from your home, the plan pays $400 per round trip for up to three trips a year. If a dependent child needs that kind of travel for care, a parent or legal guardian gets another $400 per round trip to go along. Family lodging near a non-local hospital is covered at $100 per night for up to 30 days per accident.²

What the Plan Doesn’t Cover

The biggest limit is right in the name: this is off-the-job accident insurance. Anything that happens while you’re working is excluded and would fall to workers’ compensation, or, in states like Texas where Walmart is a non-subscriber, the company’s separate occupational injury program.¹

Other exclusions in the accident certificate:²

Injuries that occurred before your coverage effective date.
Self-inflicted injuries, suicide, or attempted suicide.
Injuries sustained while under the influence of alcohol or narcotics, unless the substance was prescribed by a physician.
Injuries from committing or attempting an assault or felony, or from participating in a riot or insurrection.
Acts of war, whether declared or undeclared.
Active military service.
Cosmetic dental or plastic surgery, unless it treats an injury or corrects a functional disorder caused by the accident.
Sunburn.
Medically induced comas.

An earlier version of the brochure also excluded injuries from aeronautics (other than as a fare-paying airline passenger) and from organized racing or vehicle testing on racetracks. Check the current certificate to confirm whether those still apply.⁴

Recreational and athletic injuries are generally covered. The brochure uses a child hurt playing soccer at a park as its example claim, and doesn’t limit coverage to organized sports.³

Cost and Who Can Enroll

The plan is open to all associates who are eligible for medical coverage. Part-time and temporary associates who aren’t medical-eligible can enroll after 52 weeks of employment. There are no medical questions and no proof of good health.¹

Biweekly costs for 2026:⁵

Associate only: $0.68.
Associate and spouse or partner: $1.28, available only to full-time and salaried associates.
Associate and child(ren): $1.34.
Associate and family: $1.80, available only to full-time and salaried associates.

Miss the initial enrollment window, and your next chance is usually annual enrollment or a qualifying life event. Newborns are automatically covered for 60 days; to keep that coverage past 60 days, update your tier within that window.³

Filing a Claim

The Standard handles claims. File online at standard.com/ahl/mybenefits or call 1-800-514-9525 (Monday through Friday, 8 a.m. to 8 p.m. ET).⁶ You’ll need a completed claim form, authorization to release medical records, and itemized bills showing dates of service, diagnoses, procedure codes, and charges. Depending on the injury, radiology or operative reports, hospital records, ambulance bills, police reports, or blood alcohol results may also be required.⁷

Written proof of a claim is due within 90 days of each loss. If that isn’t possible, the plan will still accept it as long as you file as soon as reasonably possible and no later than 15 months from the date of loss, unless the covered person is legally incapacitated.²

Not the Same as AD&D

Walmart’s Accidental Death and Dismemberment plan is a separate product. AD&D pays a lump sum if you die or suffer a qualifying loss such as a limb or eyesight, covers on-the-job and off-the-job accidents, and offers coverage from $25,000 to $200,000 for hourly associates and up to $1 million for salaried associates and full-time truck drivers.⁸ The voluntary accident plan does none of that. It pays smaller, itemized amounts for medical treatment after off-the-job accidents, and you can enroll in either plan without the other.

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Walmart OneWalmart. Accident Insurance
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Walmart. Accident Certificate
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Allstate Voluntary. Walmart Accident Insurance Brochure
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Walmart. Accident Insurance Brochure 2020
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Walmart. 2026 Benefits Rates
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Allstate Voluntary. Walmart Voluntary Benefits
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Walmart. Walmart Group Accident Claim Form
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Walmart OneWalmart. Accidental Death and Dismemberment Insurance