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  1. #1
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    Health Insurance - US Tour - US Resident

    I have an insurance question. I'll throw it out there and see what you guys think.

    I am a US citizen, although I've lived outside of the US for a year and have no US health insurance. I am moving back to the US in a week and need to get some health insurance. I do not own a car (big city, no need), and therefore have no car insurance.

    I am going on a 2.5 month trip across the US via the Northern Tier this summer.

    My question is: can I buy a typical health insurance policy and expect to be covered in case of injury on the bike while touring?

    Since I'm moving back to the US, I would obviously buy health insurance in any case, b/c the US is not the place to risk it. But will a normal policy work for me? I have not read the fine print on any of the policies, but I've heard that bike injuries are only covered if the bike is being used for recreation occasionally, and not if you're living on your bike.

    A normal health care policy covers you in every state, correct?

    I've also heard that injured cyclists are covered via their AUTO insurance if they are struck by a motorist without insurance or without proper insurance. Not sure how this works or if it's true, but since I don't have AUTO insurance, is this an issue?

    Basically, what would you recommend for a US resident with no insurance looking to pick up something that will cover him on and off the bike, health-wise?

    **At this point, I'm only concerned with health insurance, not property insurance. I also want to apologize if this post comes across as clueless, but I'm pretty ignorant with regard to health insurance (parents' coverage, then government coverage, then overseas employer, and now...). Also, I've searched the forum and haven't come up with much, so I appreciate the help. Most threads just devolve into an angry discussion about the US health care system.

  2. #2
    Banned. Bekologist's Avatar
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    In the face of health insurance "reform", companies are slapping lipstick on the pigs and more widely offering individual policies again!

    Check out Blue Cross/Regence "Evolve" health insurance.

    Oh, I also just read about an insurance policy that is available to bicyclists as road users, not sure what it covers..... Bob Mionskes' blog might have mentioned it and this is a new development in the US insurance market.
    Last edited by Bekologist; 04-26-10 at 07:53 AM.

  3. #3
    nun
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    How old are you? Can you get on your parent's policy?

    Maybe these are the folks to contact

    http://pathlesspedaled.com/?p=359

  4. #4
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    Check the "out of network" coverage of any policy you buy. Some (most, maybe all?) policies provide reimbursement at lower rates if you are treated by out of network providers. And you may end up being responsible for the rest. Also, if you are doing AC's Northern Tier route, check for coverage in Canada since that route goes into Canada twice, albeit for a total of maybe 3-4 days.

    Regarding auto insurance, sounds like you are referring to un/underinsured motorist coverage, which would cover medical expense if you were to be hit by an un/underinsured motorist. If you don't have auto insurance, it's not applicable to your situation.
    "I've wanted you to succeed, but watching you find excuse after excuse after excuse and then laugh it off as the loveable, quirky, chubby guy is getting old."--Ill.Clyde

  5. #5
    mosquito rancher adamrice's Avatar
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    Auto insurance (yours, anyhow) does not enter into it. If you get injured on a bike, your medical care will be covered by your health insurance. If a motorist hits you and sticks around (or gets caught by the cops), the public-liability insurance he carries for his car should cover you—eventually. But that process would take months, so you'd want your own health insurance anyhow otherwise you'd be out-of-pocket on those medical expenses until the other guy's insurance covered you.

    "I've heard that bike injuries are only covered if the bike is being used for recreation occasionally, and not if you're living on your bike."

    I haven't heard that. I suspect clauses like that would be designed to avoid covering people who work on their bike, like couriers. You'd probably be in the clear, but it wouldn't hurt to ask an operator. You also need to know that insurers will find any excuse possible not to cover you after you become a liability, so it's conceivable they'd say you're cover and then deny coverage when you needed it.

  6. #6
    Long Distance Cyclist Machka's Avatar
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    If you were Canadian, I'd suggest you look for something called "Travel Insurance". Perhaps the US has that too.

  7. #7
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    Quote Originally Posted by nun View Post
    How old are you? Can you get on your parent's policy?
    I am 24, so I am eligible to get back on my mother's policy. However, I start riding in mid-May, and I believe the health insurance reforms go into effect in July. That's definitely a good thought, though.

  8. #8
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    Quote Originally Posted by indyfabz View Post
    Check the "out of network" coverage of any policy you buy. Some (most, maybe all?) policies provide reimbursement at lower rates if you are treated by out of network providers. And you may end up being responsible for the rest.
    Good advice! Before my father died, he lived in Texas and had an HMO health insurance plan that pretty much worked only in Texas. Out of state Emergency Room visits were covered, as were hospitals stays if you were admitted through the ER. Everything else was considered out of network and wasn't covered

    This sort of plan didn't seem like a problem... until he was visiting me, had some health problems that weren't significant enough to warrant an ER visit but did require a number of (expensive) tests and several (expensive) office visits to diagnose.

  9. #9
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    What you can do, is get temporary health insurance through a company such as Blue Cross.
    Too bad your a US citizen, If you were not I would say dont worry about it. You would get better care in the hospital than if you did have insurance and you wouldnt have to pay anything.
    It is not about the destination. It is about the journey getting there.
    Competitors work until they get it right, but champions work until they can't get it wrong.

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    I have Blue Cross from my company and boy did our premiums go through the roof! It seems like the insurance companies are increasing their rates as they will have to take pre existing conditions and not able to drop people! We really needed the public option because I get the feeling health insurance in this country is going to go sky high for those with good plans.

  11. #11
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    Well thanks to Obama-care. dont worry we will all be screwed when he turns the country socialist.
    It is not about the destination. It is about the journey getting there.
    Competitors work until they get it right, but champions work until they can't get it wrong.

  12. #12
    ah.... sure. kayakdiver's Avatar
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    Quote Originally Posted by mthayer View Post
    Well thanks to Obama-care. dont worry we will all be screwed when he turns the country socialist.
    Save it for P&R
    Save 15% on your first order at Hammer Nutrition!!

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  13. #13
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    Sorry, I had to throw that in. I am 28, and I hate being told, that I am going to have to get health insurance.
    It is not about the destination. It is about the journey getting there.
    Competitors work until they get it right, but champions work until they can't get it wrong.

  14. #14
    Neil_B
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    "I've heard that bike injuries are only covered if the bike is being used for recreation occasionally, and not if you're living on your bike."

    How is the insurance company going to know? And what defines "living on your bike?"

    BTW, I have a little experience, having broken a rib while on a bike tour in 2008. The nice folks at Sibley in DC didn't give me any problem when they admitted me, and my insurance didn't question the claim.

  15. #15
    Neil_B
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    Quote Originally Posted by kyakdiver View Post
    Save it for P&R
    +1!

  16. #16
    Long Distance Cyclist Machka's Avatar
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    Quote Originally Posted by LongRide34 View Post
    but I've heard that bike injuries are only covered if the bike is being used for recreation occasionally, and not if you're living on your bike.
    Here ... let me dig my latest travel insurance policy ...

    The travel insurance policies I've had (from Canadian sources) don't specify what you're doing when you travel to other provinces or countries, when it comes to cycling activities, with the exception of the clause that says,

    "1. No benefit will be payable in connection with treatment, services or expenses related to or resulting from:
    g. Professional Sports or Racing - participation in professional sports or any organized racing or speed contests"


    (It also lists Misrepresentation, Pregnancy, Intentionally Inflicted Injuries, Failure to take medicine, Alcohol or Drug Abuse, Crime (participating in criminal activities), War or Terrorism (participating in these activities), Commuting, Mental Problems (arising from a medical emergency), Hazardous Activities (like scuba diving, bungie jumping, or parachuting), and Travel Advisories)

    The other main limitations are that the treatment has to be for emergency medical coverage and it will not cover pre-existing conditions.


    Now I had to use this policy back in July/August when I developed DVT. It had become a medical emergency by the time I was diagnosed, and was not to my knowledge a pre-existing condition, so I was covered. However, there was a problem with the coverage ... they company was based in Canada, and although it was a large company, the people they assigned to me seemed unaware that Australia was on a different time zone, had different banks, and used different currency. I don't think the people I worked with for the next 5 months to settle the whole matter had ever set foot out of Canada, or at least not out of North America.

    They would call the hospital, where I stayed for 14 days (by the time I was diagnosed the DVT had become a life/death emergency), at 2 am expecting to talk to my Dr ... and not just once, many times despite the fact that the night nurses kept telling them that the hospital was a small country hospital and the Dr was only on call for emergencies at 2 am. They tried to pay everything in US funds, and when that didn't work they tried paying with a Diner's card ... both of which were really odd choices, given that they could have paid with a money order or bank draft or some such thing, which led to 5 months of difficulties.

    I don't think I'd go with that organisation again ... but it opened my eyes to some of the pitfalls of these insurance companies. If the company you're going with is a US company and you're travelling in the US, it should be OK ... but do check to make sure it covers you in all states - it might not. However, if the company you're going with is from one country and is covering you for travel in another country (which is a common enough occurance with these travel insurance policies) make some inquiries about their dealings in other countries. Check to be sure they'd know what to do if something happened to you in the other country.

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    The trouble I'm having now is in figuring out WHERE the policies are effective. Or rather, if I get hit by a car in Fargo, what are the odds that the hospital will be included in my network. I wonder if there's a site out there with a nice map of all the providers from the different insurance companies.

  18. #18
    Long Distance Cyclist Machka's Avatar
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    Quote Originally Posted by LongRide34 View Post
    The trouble I'm having now is in figuring out WHERE the policies are effective. Or rather, if I get hit by a car in Fargo, what are the odds that the hospital will be included in my network. I wonder if there's a site out there with a nice map of all the providers from the different insurance companies.
    I don't understand what you mean by "what are the odds that the hospital will be included in my network".

    My Canadian policy, from last summer, says:

    "Covered Trip means a trip:
    -- outside the Insured Person’s province or territory of residence;"

    So in my case, the policy would not have covered me if I had an emergency in Alberta, but if I'd gone to BC, Saskatchewan, the US, Mexico, France, Australia, South Africa or anywhere else I would be covered.

    As soon as a medical emergency occurs, the plan indicates that I need to call the number on the policy and the person will direct me to the nearest appropriate medical facility. Or, if the medical emergency is such that I'm booked into the nearest hospital before I can place a call, the company will determine if the place I'm located is an appropriate medical facility or not. If it is, I can stay. If it is not, they will recommend a transfer to an appropriate medical facility.

    So basically, if you're in a medical emergency situation, you just go to the closest place you can find.

  19. #19
    Neil_B
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    Quote Originally Posted by LongRide34 View Post
    The trouble I'm having now is in figuring out WHERE the policies are effective. Or rather, if I get hit by a car in Fargo, what are the odds that the hospital will be included in my network. I wonder if there's a site out there with a nice map of all the providers from the different insurance companies.
    Emergency room visits are usually covered, minus whatever deductible you have, wherever you are in the US. And, by law and tradition, ERs don't turn people away. I live 150 miles from DC, as does my doctor. But when I had a broken rib, I was examined, had x-rays taken, and given a prescription for Percoset. I spent a few minutes when being admitted with a billing agent giving her my insurance information. And a couple of weeks later I received in the mail a bill for the deductible.

    My suggestion is that you start reading a couple of policies, and when you find one that fits you, ask questions about what it says. I think you are scaring yourself needlessly.

  20. #20
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    Quote Originally Posted by Machka View Post
    I don't understand what you mean by "what are the odds that the hospital will be included in my network".

    My Canadian policy, from last summer, says:

    "Covered Trip means a trip:
    -- outside the Insured Personís province or territory of residence;"
    I guess I'm referring to non-travel insurance. Just health insurance. In the US, policies typically come with a "network" of affiliated "providers" (hospitals/doctors). If you go to a hospital in the network, the insurance covers a certain percentage of your costs (90% is pretty typical, I think). If the hospital is not in the network, the percentage is much lower (50-60%). So it's important that my policy has a wide network.

  21. #21
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    Quote Originally Posted by The Historian View Post
    Emergency room visits are usually covered, minus whatever deductible you have, wherever you are in the US. And, by law and tradition, ERs don't turn people away. I live 150 miles from DC, as does my doctor. But when I had a broken rib, I was examined, had x-rays taken, and given a prescription for Percoset. I spent a few minutes when being admitted with a billing agent giving her my insurance information. And a couple of weeks later I received in the mail a bill for the deductible.

    My suggestion is that you start reading a couple of policies, and when you find one that fits you, ask questions about what it says. I think you are scaring yourself needlessly.

    Thanks, those are good points. I appreciate the tips.

  22. #22
    Long Distance Cyclist Machka's Avatar
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    There are two different types of insurance (well, more than two, but two applicable in this situation). One is general health insurance, and from the Canadian perspective, general health insurance tends to cover special circumstances within the province of residence ... but not elsewhere within the country. Travel insurance covers emergency situations anywhere but the province of residence. General health insurance is usually purchased on an annual basis. Travel insurance is often purchased per trip, although it can also be purchased annually if you travel a lot.

    So to cover you in the province of residence you get general insurance, and to cover you elsewhere you get travel insurance ... people who like to travel get both types of insurance.

    I guess what you'd want to check in your situation is that the policy you go with covers you when you travel outside your state of residence.

  23. #23
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    Quote Originally Posted by Machka View Post
    I guess what you'd want to check in your situation is that the policy you go with covers you when you travel outside your state of residence.
    Exactly. I'm just having to dig around a bit to find that info, that's all.

  24. #24
    Long Distance Cyclist Machka's Avatar
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  25. #25
    nun
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    Your Health Insurance question is a little hard to answer as it will depend where you live. ie if you live in MA it's relatively easy to simply log onto the state sponsored website and choose from the private plans offered. Also if your annual income is low you might be able to get a subsidized plan. My advice is to call up your state's health department and ask about plans and also to go to an insurance agent and describe what you want, probably high deductible, high co-pay catastrophic policy that is nation wide.

    The folks at "pathlesspedeled.com" ended up with a plan from Celtic Insurance that sounds just right for you. You are young so you should be able to get a plan for $100 or $200 per month depending on the level of coverage. Ask about out of network coverage, most plans allow you to use certain providers when you're out of state.
    Last edited by nun; 04-29-10 at 08:32 AM.

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