General Discussion Triathlon Talk » USAT medical claim experiences Rss Feed  
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2015-10-26 1:00 PM

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Alpharetta, Georgia
Bronze member
Subject: USAT medical claim experiences

Has anyone here ever filed a USAT medical claim?

Two weeks ago, I crashed my bike during Ironman Louisville and ended up with an ambulance ride and hospital treatment for a broken fibula at the ankle. I received an email from the RD with the USAT medical claim form and some vague instructions, but no details and he could not answer my questions. He said I could email USAT with my questions directly, and I will, but in the mean time do any of you have experience here?

  1. Do I submit only race-day claims, or do I also submit claims for treatment after the race (follow up treatment/x-rays, physical therapy, etc.)?
  2. What will the USAT insurance cover? I cannot find any details online whatsoever.

I'd be interested in others' experiences and advice - please share!



2015-10-26 1:07 PM
in reply to: 0

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Champion
7036
5000200025
Sarasota, FL
Subject: RE: USAT medical claim experiences

My understanding is that the USAT insurance is supplemental insurance.  

I think this explains it:

http://www.usatriathlon.org/audience/race-directors/insurance/athlete-excess-medical-policy.aspx

Mark



Edited by RedCorvette 2015-10-26 1:11 PM
2015-10-26 1:17 PM
in reply to: lisac957

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Pro
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Subject: RE: USAT medical claim experiences

Lisa - first, sorry about your accident.  The first thing that needs to happen in order to file a claim is that the RD has to submit a report.  I would say that happened since you got an email from the RD.  You can go to the USAT site and find instructions on how to submit your claim.  If you still have questions, call USAT.  I have had quite a few occasions to call their office over the years and have always found the person on the other end of the line, no matter what department, to be helpful and accamodating.  You may be surprised, but it's a REALLY small group of folks who do the majority of the work and they are great people.  My money says you will find all the help you need there.

I wish you a speedy recovery!

2015-10-26 1:39 PM
in reply to: RedCorvette

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Alpharetta, Georgia
Bronze member
Subject: RE: USAT medical claim experiences

Originally posted by RedCorvette

My understanding is that the USAT insurance is supplemental insurance.  

I think this explains it:

http://www.usatriathlon.org/audience/race-directors/insurance/athlete-excess-medical-policy.aspx

Mark

Yes I read that but it does not answer any of my questions

2015-10-26 1:41 PM
in reply to: Left Brain

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Alpharetta, Georgia
Bronze member
Subject: RE: USAT medical claim experiences

Originally posted by Left Brain

Lisa - first, sorry about your accident.  The first thing that needs to happen in order to file a claim is that the RD has to submit a report.  I would say that happened since you got an email from the RD.  You can go to the USAT site and find instructions on how to submit your claim.  If you still have questions, call USAT.  I have had quite a few occasions to call their office over the years and have always found the person on the other end of the line, no matter what department, to be helpful and accamodating.  You may be surprised, but it's a REALLY small group of folks who do the majority of the work and they are great people.  My money says you will find all the help you need there.

I wish you a speedy recovery!

Thank you - yeah I think I will just have to contact USAT directly.

Still hoping to hear some wildly successful stories of how USAT handles claims and what I can expect - surely one of us has been through this?

2015-10-26 3:52 PM
in reply to: lisac957

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Not a Coach
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Media, PA
Subject: RE: USAT medical claim experiences

First, like LB, I am sorry to hear about your accident and hope you have a speedy and full recovery.

To get your questions answered, you are going to have to call USAT.

But, just to give you some (very) rough idea of what to expect, USAT provides an excess medical policy.  This means your primary medical policy (assuming you have one) will deal with most of your claims.  The USAT policy would pay a portion of whatever your obligation is after insurance.  So, for example, assume your 'out-of-pocket' costs  (deductibles, co-pays, etc.) under your primary health insurance were $2,000.  USAT's policy probably has an 'excess deductible'.  I have no idea what this is, but say it is $500. USAT's insurer would then pay $1,500 of the $2,000, leaving you with $500.  If your out-of-pocket was less than $500, then USAT's insurer would not pay anything.

As to what total expenses that policy will include (follow-up, PT, etc.), I don't know.  And I don't know if there is an upper limit, what the deductible is (often different if you have/don't have your own health insurance), or any possible exclusions.  And that's a good reason to pick up the phone and get them to walk you through everything ASAP. 



2015-10-26 8:38 PM
in reply to: JohnnyKay

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Veteran
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Virginia Beach
Subject: RE: USAT medical claim experiences
I crashed in a race a few years ago... broken collarbone, scapula and couple ribs. Freak accident and I needed surgery to repair the clavicle.

Anyway, I had a HSA high deductible plan and was able to get reimbursed by a company USAT contracted with (American Specialty at the time) for almost $2,000.

So the process works under the right circumstances with insurance, race director etc.... but it takes time and paperwork. I had to send EOB's, proof of my out of pocket costs etc. The healthcare providers needed to send info too if I recall correctly.

It is not something I try to remember, but PM me if questions.

2015-10-28 9:17 AM
in reply to: burkesj

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Alpharetta, Georgia
Bronze member
Subject: RE: USAT medical claim experiences

Just updating this for anyone who might be doing a future search...

I spoke with the guy who handles USAT medical claims, and was informed that after my primary insurance kicks in, I will pay a $250 deductible and everything else *should* be covered under the USAT insurance. The best news of all is that I can submit claims for any treatment up to 52 weeks after the incident - so this should cover my many follow up appointments, x-rays, medications and even physical therapy. Really happy to hear that

2015-10-28 9:30 AM
in reply to: 0

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Pro
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Subject: RE: USAT medical claim experiences

Originally posted by lisac957

Just updating this for anyone who might be doing a future search...

I spoke with the guy who handles USAT medical claims, and was informed that after my primary insurance kicks in, I will pay a $250 deductible and everything else *should* be covered under the USAT insurance. The best news of all is that I can submit claims for any treatment up to 52 weeks after the incident - so this should cover my many follow up appointments, x-rays, medications and even physical therapy. Really happy to hear that

Good deal! That makes all of your USAT membership fees worth it.



Edited by Left Brain 2015-10-28 9:30 AM
2015-10-28 10:18 AM
in reply to: Left Brain

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Extreme Veteran
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Maryland
Subject: RE: USAT medical claim experiences

sweet! glad to hear its working out!

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