Health insurance for moto

kb228
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kb228
Edited Date/Time 1/28/2019 1:48pm
I currently have medical mutual through my employer. Recently i was denied coverage for an accident i had in september that resulted in a broken leg and collarbone. They said even though i wasnt racing its still a hazardous activity and isnt covered. Unfortunately im stuck with a $70,000 bill for inpatient at the hospital. Although im trying to appeal the claim, i want to start looking for insurance thats applicable to a 25 year old who doesnt get sick. Something that covers things young people do that cause injuries.

Anyone have experience with a good company? Im in ohio
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Sweetd31
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Sweetd31 11/13/2018 9:37am
11/13/2018 9:37am
Private market sucks for the young and the old, at least here in Texas. I rely heavily on my job for insurance. Also hospital usually will take a significant reduction if you negotiate. Best of luck, I am interested in others' responses.

Get well soon
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MotoMatt_928
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MotoMatt_928 11/13/2018 9:42am
11/13/2018 9:42am Edited Date/Time 11/13/2018 9:42am
Depending on who you have for your employer's insurance, you should be able to get supplementary accident insurance. For example, I have Blue Cross Blue Shield as my PPO, and then I have MetLife voluntary accident for an additional cost. If your employer does not offer that, you should be able to get it on your own. In that case, I would reach out to MetLife directly.
kb228
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kb228 11/13/2018 9:52am
11/13/2018 9:52am
Langhammx wrote:
Aflac
I looked into aflac, it sounds like they just write a check for 10k or so for a broken leg for example. I dont know if they have something that covers a 70k bill

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motomike894
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motomike894 11/13/2018 9:55am
11/13/2018 9:55am
Our insurance is thru my wife because she works for the state so its very cheap for us, but its not great insurance ( although most insurance sucks now anyway ).

But I have been injured pretty bad twice in the 12ish years or so we have been on it and its never been an issue at all, both times I had to take an ambulance as well.

We have Anthem.
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Jbulz
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Jbulz 11/13/2018 9:56am
11/13/2018 9:56am
I think I would lawyer up if I were you
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Luxon MX
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Luxon MX 11/13/2018 10:04am
11/13/2018 10:04am
Kasier works well for me. They had no problem covering my ACL and various other moto related injuries. I've only ever paid the copay.
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DerickYZ
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DerickYZ 11/13/2018 10:19am
11/13/2018 10:19am
I would be appealing the claim. I know when I broke my wrist in July I went to the hospital and for the doctor to see me (for a maximum of 5 minutes and tell me it was broke) was $6,000. After appealing, I paid only $100.

Hospitals will work with you. As for insurance, I’m in the same boat. My work insurance kind of blows but it’s better than nothing. Looking for suggestions as well!

Here’s some pictures of my wrist that cost me $28,000. 2 hour surgery, titanium plate and 8 screws.







Derek Harris 11/13/2018 11:43am
11/13/2018 11:43am
Jbulz wrote:
I think I would lawyer up if I were you
Agreed

Driving a car is dangerous
Walking on stairs is dangerous
Riding a bicycle is dangerous - more so if you commute than recreational - cars are big
Football, soccer, basketball, dangerous
The gym is dangerous
Hiking is dangerous

While their point is valid mx is dangerous - you can get seriously injured doing just about anthing

Over 90 percent of spinal chord injuries come from car wrecks
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Frank
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Frank 11/13/2018 11:49am
11/13/2018 11:49am
Its a federal law that everyone in the usa pay for health insurance or get a tax penalty. A "good" plan is $180 per month per person premium with a $5,000 per person annual deductible. Unless you lie they will not cover motocross racing accidents as they should since they are self inflicted. If they do cover it most have a cap of $10,000/yr. More importantly they can charge any amount they want since their are no regulations. I am making payments on a $1,700 ACE wrap bandage lol. That is the state of health care in the usa.
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kb228
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kb228 11/13/2018 11:51am
11/13/2018 11:51am
Jbulz wrote:
I think I would lawyer up if I were you
Derek Harris wrote:
Agreed Driving a car is dangerous Walking on stairs is dangerous Riding a bicycle is dangerous - more so if you commute than recreational - cars...
Agreed

Driving a car is dangerous
Walking on stairs is dangerous
Riding a bicycle is dangerous - more so if you commute than recreational - cars are big
Football, soccer, basketball, dangerous
The gym is dangerous
Hiking is dangerous

While their point is valid mx is dangerous - you can get seriously injured doing just about anthing

Over 90 percent of spinal chord injuries come from car wrecks
This is my logic. Wheres the line between falling on soft tilled dirt at 20-35mph and falling on a road at 60mph with cars and semis? Im sure anyone who rides both can agree they have more close calls on the street than off road from being hit by a car.
kb228
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kb228 11/13/2018 11:52am
11/13/2018 11:52am
Frank wrote:
Its a federal law that everyone in the usa pay for health insurance or get a tax penalty. A "good" plan is $180 per month per...
Its a federal law that everyone in the usa pay for health insurance or get a tax penalty. A "good" plan is $180 per month per person premium with a $5,000 per person annual deductible. Unless you lie they will not cover motocross racing accidents as they should since they are self inflicted. If they do cover it most have a cap of $10,000/yr. More importantly they can charge any amount they want since their are no regulations. I am making payments on a $1,700 ACE wrap bandage lol. That is the state of health care in the usa.
I agree. Only problem is i wasnt racing and was still denied.
motomike894
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motomike894 11/13/2018 12:54pm
11/13/2018 12:54pm
Frank wrote:
Its a federal law that everyone in the usa pay for health insurance or get a tax penalty. A "good" plan is $180 per month per...
Its a federal law that everyone in the usa pay for health insurance or get a tax penalty. A "good" plan is $180 per month per person premium with a $5,000 per person annual deductible. Unless you lie they will not cover motocross racing accidents as they should since they are self inflicted. If they do cover it most have a cap of $10,000/yr. More importantly they can charge any amount they want since their are no regulations. I am making payments on a $1,700 ACE wrap bandage lol. That is the state of health care in the usa.
$180 a month is cheap lol even for one person.
numba1 fan
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numba1 fan 11/13/2018 1:03pm
11/13/2018 1:03pm
Man that sucks to hear! I broke my leg when i was in College from riding and it required surgery. I go through with the surgery and all the physical therapy that was included by my insurance to then later receive a bill saying that they would not be covering it because i was injured on a motorcycle. They said that if i had been on an ATV they would cover it but not for a motorcycle. Such a joke! I learned that pretty much you should always say you just fell down the stairs so that they cant come back and find an excuse to deny you!
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sandman768
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sandman768 11/13/2018 2:25pm
11/13/2018 2:25pm
Your best bet is to never mention motorcyclcle....Does your state have some kind of regulation requarding road motorcycles? In NYS no fault medical does not apply to road bikes..... Make sure they know it was a sporting event, not a road bike accident. I had to battle a bit this past summer for my ACL repair as it was mistakenly reported as a Motor vehicle accident, as in Road bike... My medical coverage started denying my bills, After several phone calls to explain off road= dirt bike, they agreed to pay the bills...I worked in the Insurance field for 25 years, I still had a hard time explaining to the Reps the difference between road bike & dirt bike.... From now on when I get hurt, it will be " in my backyard playing basketball" if you know what I mean....
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RichieW13
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RichieW13 11/13/2018 2:35pm
11/13/2018 2:35pm
Derek Harris wrote:
Agreed Driving a car is dangerous Walking on stairs is dangerous Riding a bicycle is dangerous - more so if you commute than recreational - cars...
Agreed

Driving a car is dangerous
Walking on stairs is dangerous
Riding a bicycle is dangerous - more so if you commute than recreational - cars are big
Football, soccer, basketball, dangerous
The gym is dangerous
Hiking is dangerous

While their point is valid mx is dangerous - you can get seriously injured doing just about anthing

Over 90 percent of spinal chord injuries come from car wrecks
Sure, but the injury rate for riding mx is much higher than those other activities.
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LumpDog841 11/13/2018 3:29pm
11/13/2018 3:29pm
Little advice to everyone if they ask you what happened DO NOT mention anything to do with motorcycles or motocross. Just say you fell, and nothing else. Isn't any of their business. If you're regular health insurance hears anything with motorcycles, they will push it to auto insurance....and then they will fight, while you're stuck with the bill.
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kb228
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kb228 11/13/2018 3:36pm
11/13/2018 3:36pm
Lying to insurance is fraud.. and its hard to say you fell down stairs when youre in an ambulance in your dirty riding gear lmao
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peelout
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peelout 11/13/2018 4:24pm
11/13/2018 4:24pm
Langhammx wrote:
Aflac
x2 on Aflac bros
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jjavaman
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jjavaman 11/13/2018 4:55pm
11/13/2018 4:55pm
My god, what is wrong with the US? It’s called universal health care, pretty well every 1st world country has it. I don’t mind paying a little extra on the taxes so when guys get hurt doing something they like (mx,mtn biking,etc) they don’t have to worry about financial ruin. What’s so hard to understand??
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zehn
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zehn 11/13/2018 4:57pm
11/13/2018 4:57pm Edited Date/Time 11/13/2018 5:04pm
jjavaman wrote:
My god, what is wrong with the US? It’s called universal health care, pretty well every 1st world country has it. I don’t mind paying a...
My god, what is wrong with the US? It’s called universal health care, pretty well every 1st world country has it. I don’t mind paying a little extra on the taxes so when guys get hurt doing something they like (mx,mtn biking,etc) they don’t have to worry about financial ruin. What’s so hard to understand??
There are far too many reasons for why we don’t have universal/single-payer to write out on Vital.
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smashingpumpkins167 11/13/2018 5:15pm
11/13/2018 5:15pm
I would first try re submitting your claim. I've heard that they automatically deny a certain percentage of claims right off the bat just to be dicks. They should pay it.
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sandman768
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sandman768 11/13/2018 5:23pm
11/13/2018 5:23pm
Langhammx wrote:
Aflac
Aflac is more like lost wages, better than nothing but not meant to cover medical expenses, unless the policy specifically covers medical expense.
sandman768
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sandman768 11/13/2018 5:32pm
11/13/2018 5:32pm
Again, this is state specific, but get online and see if your state has an Insurance Dept. likely you do & you can file a formal Insurance dept. complaint for your claim being denied. Once that is in motion, the Insurance company has to repsond to the Insurance dept. and you. Your Insurance company has a time limit once they are put on notice from the complaint, to repsond. Insurance company claim depts. donot like Formal complaints from their state Insurance dept"s & they will fast track your claim for payment or better have a dam good reason to deny you. I was an Insurance adjuster for 25 years, when a state dept. complaint comes in, shit happens. You don't need an attorney....yet.
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sandman768
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sandman768 11/13/2018 5:44pm
11/13/2018 5:44pm
kb228 wrote:
Lying to insurance is fraud.. and its hard to say you fell down stairs when youre in an ambulance in your dirty riding gear lmao
You are correct, misrepresentation of facts is fraud. Unfortunetly we are not playing on a level field. If you are a " clean hands" policy holder...I.E. Premiums paid, not under the influence of drugs or alcohol and not participating in an unlawful or criminal act, a good insurance company adjuster, Should look for ways to PAY your claim not look for ways to DENY your claim.
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731chopper
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731chopper 11/13/2018 6:15pm
11/13/2018 6:15pm
Healthcare is so F’d in this US. The ACA only compounded the un-affordability for most people. The individual mandate goes away next year which is good because it will make the insurance companies have to create semi-attractive products. Unfortunately, getting hurt on a motorcycle will still be excluded by health insurance for many people and most people don’t even know it because they don’t read their policies.
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motofool
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motofool 11/13/2018 6:22pm
11/13/2018 6:22pm
blaze 57
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blaze 57 11/13/2018 6:35pm
11/13/2018 6:35pm Edited Date/Time 11/13/2018 6:36pm
About 10 yrs ago my wife was between jobs thus waiting for our insurance to kick in and she goes into cardiac arrest while driving. Fortunately she safely pulled over. Long story short she ended up with light heart surgery (ablation) and a pacemaker and we were stuck with a $165,000.00 bill, no kidding!

We ended up getting an attorney and she looked into the billing and actual cost and told us the hospital only had $9,500.00 total into it. We were finally able to negotiate the hospital from 165,000.00 down to 12,000.00 so there quite a bit of leeway for negotiation on your billing.
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Premix
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Premix 11/13/2018 7:04pm
11/13/2018 7:04pm
In Ohio? Start here for medical:

Ohio Department of Insurance- Health Benefit Review and Appeals

Has your provider submitted to you the policy language that states the exclusion they are denying? I’m curious as to how this reads.

If all else fails and you get stuck, negotiate the shit out of those bills.
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harescrambled 11/13/2018 7:26pm
11/13/2018 7:26pm
kb228 wrote:
I currently have medical mutual through my employer. Recently i was denied coverage for an accident i had in september that resulted in a broken leg...
I currently have medical mutual through my employer. Recently i was denied coverage for an accident i had in september that resulted in a broken leg and collarbone. They said even though i wasnt racing its still a hazardous activity and isnt covered. Unfortunately im stuck with a $70,000 bill for inpatient at the hospital. Although im trying to appeal the claim, i want to start looking for insurance thats applicable to a 25 year old who doesnt get sick. Something that covers things young people do that cause injuries.

Anyone have experience with a good company? Im in ohio
I'd recommend getting some full coverage insurance on your bike. It'll pay in the event you hurt yourself, damage the bike, run over your trail riding buddy, damage property or another motor vehicle, etc. It won't cover you while racing but it's better than getting crapped on by your health insurance provider. I have full coverage through Markel Insurance for my '18 CRF450RX, $1000 in accessories, theft, fire, collision, etc...same as full coverage for your car. Costs me $250/yr. Doesn't cover you while racing or practicing to race

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