US health insurance and mtb

C

Chargeride

Well-Known Member
I watch endless videos of ridiculous mountain bike stunts in the States, amateurs and professional, but how does this relate to your private health insurance.
Do you need to tick an extra box on the form, are you free to be reckless?
Do pressure groups turn up with pitchforks against risky sports because you are increasing everyones premiums.

Do only people with insurance push the envelope, or am I watching kids risking a lifetimes debt to do a backflip?
 
Chargeride said:
I watch endless videos of ridiculous mountain bike stunts in the States, amateurs and professional, but how does this relate to your private health insurance.
Do you need to tick an extra box on the form, are you free to be reckless?
Do pressure groups turn up with pitchforks against risky sports because you are increasing everyones premiums.

Do only people with insurance push the envelope, or am I watching kids risking a lifetimes debt to do a backflip?
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All good questions. My wife the retired health care executive knows the health insurance biz fairly well — at least from a provider perspective. She's never heard of coverage exclusions for injuries due to stupid stunts or other unnecessary risks. But that doesn't mean they never happen.

Another question along these lines: What responsibilities do sponsors like Red Bull bear toward injured riders? Do they help with medical bills? Do they require or provide insurance coverage beforehand? Is the coverage adequate for a lifetime of quadriplegic care?

These young stunt riders are the gladiators of our time — there to risk life and limb for our entertainment. Their immature sense of invulnerability is being exploited — quite cynically I think — for the lofty goal of profit enhancement via image advertising.
 
From what I've seen here in the US, there are insurance riders required for some high risk occupations, but I'm not aware of any for amateur cyclists.
 
It pops up now and then for the nhs, fat, smokers, skydivers, drinkers ,anti vaxxers, brexit voters 😂.
Of course its only been a matter of time before old people popped up and now we have the assisted suicide bill just passed.
 
It turns up more often with life insurance or disability than health insurance. Probably they think the risks of being physically active in a possibly risky activity are less than the risks of being inactive. And they are probably right.

A lot of life insurance (really death insurance) has fine print about dangerous activities. Although their definitions of dangerous are often kind of ridiculous in my opinion.
 
Chargeride said:
Do you need to tick an extra box on the form, are you free to be reckless?
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Never saw anything on our health insurance over the years. But on the overseas travel medical insurance we use there is an upcharge for listed higher risk activities.
 
Chargeride said:
I watch endless videos of ridiculous mountain bike stunts in the States, amateurs and professional, but how does this relate to your private health insurance.
Do you need to tick an extra box on the form, are you free to be reckless?
Do pressure groups turn up with pitchforks against risky sports because you are increasing everyones premiums.

Do only people with insurance push the envelope, or am I watching kids risking a lifetimes debt to do a backflip?
Click to expand...
I can tell you one thing many times I have forced into situations against my better judgement were I was injured or risked getting hurt,I got hurt at Lowes(the lumber market rip off) because of someones stupidity and had lost work and medical expense.it was documented(all I was trying to do was get a little help on the medical bills( not get a retirement ticket to the Caribbean) their "inhouse" branch in the same building sez"unfortunately the investigation has decided they had no liability in this case,in so many words) so screw them,thought about OHSA, anyway I kept my
"sword sheathed" and decided to let it go avoiding doing any business with Lowes when possible,don't need their crappy lumber anyway.
 
As someone who has put themselves in the hospital a few times both mountainbiking and skateboarding, I don't remember anyone really caring how I was hurt. I showed up with broken bones/road rash/etc, the emergency room stabilized things, then booted me out with a referral to whatever specialist necessary (orthopedic doc/surgeon generally) and I followed up with them. Insurance covered whatever they were required to cover and I got stuck with the rest.

I mean, even with good insurance, visiting the hospital is pretty expensive in the US; several hundred to a few thousand was what each incident cost me in the end. So I'm not motivated to do it again if I can help it.

And sure, people doing risky stuff can cost the insurance company, but I imagine that unhealthy living (smoking, eating poorly, obesity, etc) is much more costly in the long run than needing bones repaired sometimes. Do other countries national systems, like, not cover you if you were doing something unapproved? Is there a list of things that isn't covered?
 
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Youtube & facebook videos are an incentive to stupid behavoir. In the sixties I never thought of doing any of the stupid things people do now. Dozens of people fall taking selfies at scenic overlooks.
I've fallen off the bike dozens of times, was hit by cars 3 times, hit&run once. Three hospital visits for stiches, one with a broken jaw. Last e-room visit was when I was moving a shed roof that had blown off. 12 Stiches. Insurance code does not even mention I needed sutures. Code said I needed attention of a physician. Hospitals keep them guessing. I could have had heart irregularity, Medicare has no idea.
 
No, you are free to do pretty much anything in the UK, they did go through a period of claiming off vehicle insurance for road accidents, but lost interest.
probably cost more in lawyers.
You can also get rescued at sea or mountain for free, though if youre being reckless you will get a public shaming in the papers.
 
since most americans are covered through their employer, with the insurer guaranteeing coverage of a group, there isn’t really any practical way to charge someone more for being an MTB bro, for example. and once someone is injured, care is needed and will certainly be given. i have never heard of an insurance claim being denied because the injury could have been prevented, but certainly the subrogation process can be used to go after someone else if they’re to blame for the injury. a few times we’ve had minor trauma type injuries we get very persistent calls from the insurance company trying to convince us that we got hit by a car, did we get their insurance etc.

an interesting twist on this is that i have an inherited cardiomyopathy, a very expensive one, which is exacerbated by high intensity aerobic activity. people who have this are advised to take it easy. in the more extreme cases, those who don’t take it easy end up getting transplants after a long period of increasingly expensive care. i have NEVER heard of insurance not covering these things - or letting someone die - because they did something strictly against their medical advice.

my case is not so cut and dry, both based on the genetics and presentation, but there are many people who are told : “do not exercise,” they do anyway because they love it, they get extremely sick, and millions of dollars are spent. could we have a system where full coverage required compliance with your doctors’ advice? don’t drink, smoke, get fat, etc? and what would we do for the people who ignored it? lots of people get heart disease without doing anything wrong, so who would be to say that an obese carnivore got heart disease because of their behavior and not just bad luck…
 
A lot of the really crazy mountain bike videos I've seen are done by folks in their early 20s. Some portion would still be under their parent's insurance.

Regardless, no insurance company is asking if you mountain bike as one of their questions when you sign up.
 
mschwett said:
since most americans are covered through their employer, with the insurer guaranteeing coverage of a group, there isn’t really any practical way to charge someone more for being an MTB bro, for example. and once someone is injured, care is needed and will certainly be given. i have never heard of an insurance claim being denied because the injury could have been prevented, but certainly the subrogation process can be used to go after someone else if they’re to blame for the injury. a few times we’ve had minor trauma type injuries we get very persistent calls from the insurance company trying to convince us that we got hit by a car, did we get their insurance etc.

an interesting twist on this is that i have an inherited cardiomyopathy, a very expensive one, which is exacerbated by high intensity aerobic activity. people who have this are advised to take it easy. in the more extreme cases, those who don’t take it easy end up getting transplants after a long period of increasingly expensive care. i have NEVER heard of insurance not covering these things - or letting someone die - because they did something strictly against their medical advice.

my case is not so cut and dry, both based on the genetics and presentation, but there are many people who are told : “do not exercise,” they do anyway because they love it, they get extremely sick, and millions of dollars are spent. could we have a system where full coverage required compliance with your doctors’ advice? don’t drink, smoke, get fat, etc? and what would we do for the people who ignored it? lots of people get heart disease without doing anything wrong, so who would be to say that an obese carnivore got heart disease because of their behavior and not just bad luck…
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my first major employer just went half and half on the health insurance after 26 years,the second time I worked for him a bit he didn't even offer health insurance as a benefit( that 12$ an hour was going to bankrupt him I suppose of course he had plenty for new john Deere tractors acres and acres of land plus hunting camp as and hunting trips to the northwest, when I was a foreman he didn't even let me take a company pickup home-that $4.50 an hr( top pay I guess) his company paid then was really stretching it.he got his panties in a twist when I asked him about why the company truck which I serviced and picked the guys up got 10 hrs on the time sheet while the foreman(me) got 9 . Appalachia just kept on rewarding I guess,I did notice most of my acquaintances had to leave the area to get a nest egg,of course back in the day when I was job seeking you literally couldn't buy a minimum wage job, you had to face the ristk of imprisonment if you put a wrong employer on your unemployment work search that 50-80$ a week sure stretched the bank accounts of the state and employers.One other little humorous thing I noticed we were working in the
'paper mill and I was knocking down probably$230 a week take home for 45-50 hrs went to the bank next door to deposit feeling good about my hard physical work,noticed a Guy from the" mill" itself(or another contractor) depositing his check for about $700.I wilted ( thank God for unions I suppose) so wage slavery was alive and well and you wonder why some people never seem to get ahead.
 
Mr. Coffee said:
So tell me how exactly you would make a house less expensive than a TV?
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Move to a part of the country that has surplus houses. I did. Housing market crashed here after the nuclear plant they were building was cancelled. I bought at the market bottom. Got the house for 1.2 times my annual salary at the new job.
I left Houston because every time I got a raise, rent went up more. Never could save a down payment. I saved my down payment for this house while in the Army, where they paid me extra to live off base. Bought the house there right after the railroad cancelled that town as a crew change point. House was 0.7 of my annual salary. Town was 30 miles from the Army base.
 
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Mr. Coffee said:
So tell me how exactly you would make a house less expensive than a TV?
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I was referring to their price evolution.
TVs used to be be far more of a house price and now the two have gone in completely different directions compared to wages.
Americans can easily afford luxuries like iphones, but houses have just left the stratosphere.
 
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