The Amex coverage that you pay for is $19 in Georgia, although I think it is a little more in some states. I have signed up for it and then if I pay the rental with my Amex card, they charge me a one time charge of $19 for the entire rental. This is primary coverage and means you don't have to go through your own insurance agency. There are a few countries that are not included and it doesn't cover RVs or off-road vehicles. For me, it is worth it for peace of mind, although thankfully I haven't had to file a claim.