hbc07 said:
In rehab now. Painkillers on the reg. Wanted to discuss something on the financial side though. This year when I signed up for my USAC racing license, I for no specific reason decided to "splurge" for the Race+ package which includes a supplemental accidental insurance despite never thinking I would actually use any of the insurance.
This accident is 100% going to max out my deductible and out of pocket given the surgery, 3 week hospital stay, and various medical equipment I'll need to obtain But the supplemental insurance covers up to $25k out of pocket per incident whether racing, communing, group ride, etc.
I have not found very many reviews of how people's claim processes went (other than one guy who's reimbursement took a while and got slightly less than he thought he should). My initial gut feeling is that the extra $40 or whatever it is now on top of the racing license is totally worth it. Even if I run into some problems and they reimburse only $24k instead of $25k, still worth it.
Still a little bit of time until the bills start rolling in and I have to go through the claims process for the supplemental insurance, but once that happens, I intend on posting updates here on the process just so people know.
Update on the USAC supplemental insurance coverage:
It's been a little tedious, but nothing too insane. To get them to cover the out of pocket costs you have to send in bills, EOBs, superbills and other kinds of supporting documentation. Eventually they gave me the policy information for the plan. Once I had that and could just have the providers bill directly, it's been running much more smoothly. The weird part is that for some claims I'm getting checks made out to me, and other claims are being paid directly to the provider.
The hardest part is you submit information into a black box and get no feedback or response until you get a letter 3 weeks later generically saying "We need more information about this claim"
Provider 1 claim 1: $436.82. Full amount paid directly to provider.
Provider 1 claim 2: $67.56. Full amount paid to me via check.
Provider 2 claim 1: $3,046.22. Full amount paid to me via check.
Provider 2 claim 2: $390.95. No information rec'd.
Provider 2 claim 3: $5.68. No information rec'd.
Provider 3 claim 1: $207.12. No information rec'd.
Provider 4 claim 1: $97.44. Haven't submitted yet.
Provider 5 claim 1: $2.581.31. After not being covered by my primary insurance, the hospital appears to have waived this balance.
Provider 5 claim 2: $3,447.36. After not being covered by my primary insurance, the hospital appears to have waived this balance.
Prescriptions: ~$75.00. So far I have received 0 information about the prescriptions I had filled. Nothing about being covered or not being covered (which according to the terms should be 100% covered.
So currently ~$3,550.00 covered, and ~$800.00 still pending. I'd say that the supplemental insurance was obviously worth it.
Overall numbers:
Total claims submitted to insurance: $348,178.18 and counting
Paid out by insurance: $87,016.11
Handwaived away by insurance: $241,729.28
In dispute due to bad communication between PT and insurance: $4,946.60 and counting
Have been up and walking since end of August. Lots of ups and downs still. Have been on the trainer 2 or 3x a week since then; PT has been kicking my butt now that I'm weight bearing so I'm focusing on that more than anything else. I'm currently doing rides on SYSTM that would have been recovery rides before but are now very challenging. The guys that I ride with (probably over 200 rides with them over the last 2 years) got me out for a controlled environment road ride last sunday: 20mi/16mph/120w. I'm happy with where I'm at, but long for where I was.
