$25,000 Accident Injury Coverage: Get your card ONLINE!!!

I'm a huge, Huge, HUGE fan of VBA's 24h Accident Medical Coverage...

Why?  Because every client who has ever used the claims process LOVED it, and they've never quit.  Retention in the insurance world means that the policy works.

Up to $25,000, for your family, for about $100/month?  Even a Prop realizes that's a good deal.

VBA just announced that you can get your cards online, instead of waiting the usual 4-6 weeks for the packet to come in the mail... (yes, I know... dinosaurs sent mail...)  The link is emailed after you enroll.

Just one more reason...

VBA INCREASES limits to $25,000!!!!! Rugby Included!

Attention Rugby Players who think they can't afford REAL insurance:

For $100 a month, you can have up to $25,000 in Accident Injury coverage through VBA!!!  (I love VBA.  I have hockey players, GAA cats, Rugby, Brazilian Judo... you name it!  as clients...)


So, let's say you play year round... for $1,200 a year, you're covered for $25,000 in injuries, accidents, both sports and any other incidents... ($275 deductible, I believe...).

This plan will work with USAR(FU)'s coverage, and is PERFECTLY suited to supplement a primary health plan, individually owned, or through work....

Who's in?

VBA Hurls into the GAA!

My favorite Accident Medical Plan is VBA's 24h Accident Medical Cover.  $10,000 in cover for under $60/month for individual. Add $10 and you can include the Kids and the Spouse!

Some examples:

Rugby #8 dislocates elbow:  Ambulance, ER, MRI, Reset, and PT.  His health insurance deductible was $2,500, and he bought just $2,500 in cover (Cheap Irish!).  Anyway, his total out of pocket was $250!  All for under $40 a month!

Hockey Family:  4 out of 5 in the house play Hockey.  They've all filed claims, never once been canceled or rates raised for over 2 years! Each incident was a $275 deductible, but that's better than their $12,000 health insurance deductible that they'd be forced to cover with VBA!

Kick the ball to us for more details.

Covering the deductible of an insurance plan with a Supplemental

To reduce costs, many people opt for a higher deductible for their health insurance.  Do you have the cash on hand to cover that in case a prop falls on you?

A simple and cheap way to fill the deductible "space" is with a supplemental policy from VBA.  Be sure to enroll before the beginning of training, and then cancel, if you like (I'd keep it, since it's good for non-rugby too!) after the season ends.  Rates and Benefits vary, but you can enroll here.

[Note:  There is a small deductible for the VBA also:  $195 to $275.  But that's still nicer than $2,500!!!]

Rugby is about putting the ball into space for your teammate to run onto it.  The gap can be tiny or huge, and timing is the key.  For $35-65/mo extra, you can have the cash(the ball) to go into the space (deductible), and having the timing just right.

The Problem with Rugby-only Excess Insurance Plans

My Rugby-only Excess Insurance plan is becoming popular. Most understand that it's EXCESS coverage, to pay for deductibles and co-insurance. That's a good scrum.

Here's my challenge: If you don't have a base-level of health insurance, even a catastrophic plan (High Deductible, probably under $100 a month), I don't want to sell you the Excess plan. That's a lost line-out.

Why?

Because it's bloody irresponsible, that's why. You sign a waiver with USA Rugby declaring that you have health insurance that covers a minimum of 100k. IMHO, 30+% of Rugby players in the US don't have that coverage, from a standard health insurance policy.

Here's a few solutions:

1. The Team/League buys a group plan. Soon, you'll have a FAT option to do this. Sadly, 80% of the teams in the US won't buy it.

2. You buy a catastrophic plan for under $100 a month (Most US States, the Big Bad 5 Guarantee issue states: You're Screwed.), then supplement with either VBA's Accident Medical Expense Plan, or the Rugby only Excess plan through Sport Underwriters.

3. Don't play Rugby.

About that last option: If you tell me you can't afford insurance, I'll ask you what your last bar tab was....usually, Ruggers shut up after that.

Get insured. Don't be a burden on the Game Played in Heaven...

North American Accident/Medical Plan

Here's the credit card form for the North American Accident/Medical Plan: http://bit.ly/bGUDln

Employer dropping Benes? Here's what you do...

Your employer will drop his benefits.  Why?  Because the Obamacare penalty is cheaper, and/or, the Boss will go to an Health Reimbursement Arrangement, avoiding both the hassle of group health, and the penalty.

Here's what you need to do if you have pre-existing condition that prevents you from getting individual traditional health insurance.

Now, other plans exist that could help with Rugby injuries, so don't fret.  And, remember, in 2014, and if Obamacare is not repealed or de-funded, you can buy health insurance AFTER a prop falls on you.

Doesn't make sense, but that's how it is...

Running Claims over a period of time...The Season Long and Hard...

Yesterday, I explained how to get claims paid after a Prop falls on you.

However, some Rugby injuries required months of physical therapy to heal and get back on the pitch.  How does your health insurance company handle those claims?

My guess:  Poorly.

You'll have in your EOB (Explanation of Benefits) a limited number of PT visits.  Use 'em.  And document each time you see the Physical Therapist.  Further, get the PT office involved your case.  They have a vested interest in your health, because, simply, they'd like to get paid for what they do to you.  The PT office will have a claims manager, who probably knows more about what each insurance company is willing to pay than I do!  Together, you can work out a strategy to get the PT you need, and the money they need.

Don't shirk bills.  Communicate with both the PT office and the insurance company.  Remember, once something goes to collections, you're hosed.  It's a pain, but keep every piece of paper organized in file, and create a communications log.  A pain?  Yep?  A $1,000 bill because you forgot to send in paperwork? A much larger pain.

Now, two products could help relieve the burden of a lengthy recovery:

HSA(Health Savings Account):  If this has been funded, they you've got pre-tax dollars to help you through the PT.  Pre-tax money is like having the Feds subsidize your PT up to your tax bracket.  If you haven't funded your HSA, but have a plan that's HSA-qualified, then you can list your out of pocket expense up to that year's HSA limits ($3050 per individual for 2010).

Accident Medical Cover:  Remember, these plans reimburse YOU for stuff the insurance company doesn't pay for, as long as it's directly related to the accident or injury (up to the limit your purchase).  This INCLUDES PT after the Prop falls on you.  If you don't have a few thousand laying around, or have a funded HSA, then this plan is a no-brainer in season.

Claims...they suck.  Just like a Prop falling on you...

Prop has question...

hey Kevin,

I purchased the 24 hour accident package and was approved today-I looked it over and it appears that i belong to some membership club-can you explain to me in front row speak what I just bought.

thanks!

Phil 

Phil,

Simple.  Something in prop break by accident. (Not limited to Rugby, you could fall off your barstool, get hit by your SO, etc. etc.) Prop see doctor (either ER or minor emergency center or personal physician, irrelevant).  Doctor fix prop.  Prop gets lots of paper saying that he owes money.  Prop gives $250 to the Doctor (or, ER) because that's the deductible for the accident plan.  Then, the Prop sends copies of the paper work to his insurance agent.  (um, that's me...)  The insurance agent fills out the claim form for the prop, mostly because the prop, and this is irrespective of position, will screw it up, and cause the insurance agent to fix it later.  After a few weeks, the prop will get a check to cover the outstanding bills.  (Bills, are the pieces of paper that say you owe money.)

You cannot send in your bar tab as a claim.

Make sense?

K

Explaing Rugby (Health Insurance) to a Civilian

Ever try to explain Rugby to your Mom? Ruck, Maul, Line-out, Scrum, Touch, Knock-on, Grubber, 10m line, 22m line, 22m line kicking laws, Cut, Scissor, Skip, Loop, and, my favorite, TRY!

Health Insurance has it's own list of terms: Deductible, Co-pay, Co-insurance, Out-of-Pocket Maximum, Lifetime benefit, Mental Health limitations, preferred providers, in-network, out-of-network, authorization, premium, and, my favorite, CLAIM!

Over the three day weekend, I'll explain what each of these terms means. And, yes, you'll have that expression on your face as that friend of a friend who came out to watch a match. He, and you, will be completely fucking confused. Enjoy!

Deductible (Proper Definition): The portion of a claim not paid for by the insurance company.

Deductible (BMK's Definition): What your ass is gonna pay when you get hurt.

Example: An average ER visit is about $650. If your health plan's deductible is $500, you pay the hospital $500, and your insurance carrier will pay the $150, sorta. There's co-insurance too. Nice, huh?

In general, the higher the deductible, the lower the premium. Caution point: Your health plan might have a SEPARATE ER deductible, over and above the plan deductible.

Co-Pay (Proper Definition): A small fee you pay to see a doctor.

Co-Pay (BMK's Definition): A nickel-n-dime tactic to keep you from seeing a doctor.

Co-pays usually don't count towards your deductible (or your OOPMAX, see below). The theory is that if you pay $40 every time you visit a medical provider, you won't waste time with a headcold. The idea is cost sharing, share more of the cost with the insurance company, and you'll use services less.

Insurance companies get crushed by frequent medical visits for two reasons: The cost of services is increasing, and the paperwork is astounding. 600 Billion a year is spent in paper shuffling back and forth between providers and claims offices. Now the RAND Institute, has done a few studies on this, and yes, the higher the cost sharing between insurance company and patient tends to keep the patient away from the doctor.

Co-insurance (Proper Definition): A method to spread the cost of a loss among multiple parties.

Co-insurance (BMK's Definition): Holy shit, are you fucking kidding me? I've got to pay what?

Okay, now that you've paid your co-pay(s), and met your deductible, the remainder of the bill is split between you and the insurer. The split is typically 80/20, 80% them 20% you. (Read your policy, b/c it could be 70/30, or even 50/50 for out of network claims.)

So let's go back to the ER Example: $650 to get your head stitched. Let's hope you don't have a separate ER deductible, your main Deductible is $500, and your Co-insurance is 80/20.

$650 - $500 - $150 x 20% = $120 This is what your insurance provider will pay. How do those 300/month premiums feel now?

So your ER visit is $530 out-of-pocket to you.

[You best be pissed off by now]

Out-of-Pocket Maximum (Proper Definition): Also known as a stop-loss, it's the absolute maximum you'll pay in a year for medical expenses under your plan.

Out-of-Pocket Maximum (BMK's Definition): The final squeezing of the last drop of blood from your lifeless body.

Remember the concept of cost sharing. If you and the insurer share costs, you're less likely to use the services, and thus save the insurer money. The insurer can't control health care costs, so they control your cost sharing.

So final Example before I go work-out. Let's say a prop falls on you, and you tear you acl. Ambulance ride, ER, MRI, surgery, and physical therapy. Let's say all the bills come to $10,000.

You've got a $500 deductible plan, 75/25 with a OOP Max of $3500, like Blue Shield's PPO 500 here in CA. I'm adding the $100 ER Deductible, and the $250 out patient surgery deductible that don't go towards your OOP Max. [Oh yeah, did I mention that this shit is complicated?]

What YOU PAY:

$500 + $100 + $250 + $9,150 x 25% = $850 + $2,287.50 = $3,137.50

This is does NOT include your premiums. This plan for me (I'm 37) is $459 a month: $5508

So for this year you spent over $8600 on health care. Can you afford that?

Even better, you still have over $1200 to go to reach your OOP Max for the year.

Now I have an HSA plan, $4000 Deductible, and an Accident Medical Plan that pays $5000 per year, with a $100 deductible per incident:

What I'd pay:

$100

Add to that my premiums: $96/month for the HSA plan, and $45/month for the AMC: $1692

Remember, my plan has no co-pay, no co-insurance, no OOP Max. I spend $4000 and I'm 100% covered after that. My Accident Medical Plan pays for all the stuff my insurance doesn't minus a $100 deductible.

That's a difference of $6,853.50. And I can put back $2900 into an HSA and deduct that money from my taxable income!


Do you NOW understand why I promote HSA plans and AMC plans?

Now here's the downside of my way of doing things. If I don't get hurt, but I need to see a doctor, I pay whatever the doctor charges. This could be upwards to $200. I pay for prescriptions outright, unless they're on the Walmart list. Also, if I get a debilitating disease, I must come up with the the $4,000 every year for the deductible, not including the premiums, to keep my coverage. This is about risk analysis. I'm more likely to get hurt playing than get sick, so I chose a plan combination that covers injuries, not long term illness. I've made a choice.

I chose simplicity. And isn't Rugby essentially a simple game. Create space for the ball carrier. Simplify the rules of insurance, and health care might become as pretty as scoring tries!

If you got hurt playing Rugby, how much will your current health insurance pay for?

Rugby is expensive. Dues, boots, road trips, beer, tape, water, kit bags, and beer. Ours is an expensive ruck.

Now ask yourself this: If a Big 'Ol Prop falls on you, how much will your current health insurance pay for?

Notice I didn't use the word "cover." I asked how much they will PAY FOR!!!

Rugby injuries typically involve the ER. ER visits on most plans have a separate deductible, over and above your plan deductible. So, if you plan deductible is $1,000 and your ER deductible is $500, you're out-of-pocket $1500 before the insurance companies PAYS ONE RED CENT!

Add to that your co-insurance. What? What's that? Co-insurance is a portion of the bills that you get to share with the insurance company. Typical split is 80/20, 80% on them, 20% on you. That means, for every dollar AFTER you've paid your deductible, you PAY another $0.20. If the bill is $100 over your deductible, you owe the medical provider $20.

Example: an ER visit averages $600. You'll pay every bit of that. Your insurance won't help you until you've satisfied your deductible. Make sure you know what that is!

However, here's what's NOT included in the ER bill:

• Ambulance
• Tests done off-site
  
• Meds
• Follow-up visits

These typically bill separate.

Please don't think that if you have employer health that your safe from out-of-pocket costs. Wonder why I'm so big on Accident Medical Plans? Cuz they PAY FOR a lot of the bills that typical health insurance does not.

Friday Night Fights!!!!

Most of you are resting before your match tomorrow...yeah, over a pint. Here's what's happening on the Health Insurance Pitch:

The CA DOI pushes over Blue Shield scrum

This is why RuckingInsurance.com is no longer selling Blue Shield products. Claims must be paid, fast. As fast as a wing down the touch line. A company must NOT dick around with YOUR bills. I commend the CA DOI for this pushover try.

Chiropractic Gets Giuliani's Grin

Rudy's on board with the best therapy a Rugger can get. During the season, I'm put back together by my chiro. I suggest you do the same. And, it's tax-deductible if you have an HSA!

UCAA Changes to CBA, and Miss Passes RUGGERS

Remember that Accident Medical Insurance I typed you all to get? DON'T. Zane Benefits has decided to change underwriters, and this new side won't cover organized sports. RuckingInsurance.com will have an alternative posted here and on the home site by Monday night. Sucks, I know. Call me with any Qs: 800-605-5024.

You have a 65.9% of getting hurt playing Rugby!!!

I know these stats are crazy, but chances are you WILL GET HURT playing Rugby.

9 times out of 10 you've just tweaked something and need to sit out a couple of weeks.

But, ask yourself this: How many people hit the ER during a season?

I have had 6 incidents this year with the Lady Fog team. And we only have a four game season!

I'd like to see accident medical coverage purchased by all players. This is true Rucking Insurance. Health insurance is only good for devastating injuries and cancer. Most minor injuries are less than the plan's deductible, so the Rugger ends up wasting beer money.

Stitches, bumps, bruises, stuff done at the 'Ol Chiro are typically out-of-pocket expenses. Why not give yourself ACCESS to front-row care?

AMC's are cheap and easy. And, most people don't have the cash to cover their deductible.

If you do have 2-3k laying around, don't tell your mates, cuz you'll buying rounds all night!

Go Eagles!

Healthcare for your "Out of Town" Mates

Every team has a few. They use words like "mate" to refer to anyone, and "apples" if they're happy. They're always there when someone's buying a round. And those of Gaelic Descent, when drunk, speak in "Ironics."

But they get hurt too. Problem is that they don't typically have Social Security Numbers, so they can't get Health Insurance.

So, use the last refuge of the uninsurable: medical discount cards.

These cards ARE NOT Insurance. If anyone tells you, "It's the same thing," they are LYING.

These cards are hit or miss, so research well. I recommend AmeriplanUSA. I needed an MRI and it was only $400, instead of the 2k they normally charge. Plus, all the minor emergency medical centers are on the Ameriplan network. An ulsterman teammate needed 15 stitches on his brow, had to pay a total of $120. Not bad. You can go to an MD for $42, which is twice of a normal copay. It's not insurance. It's basically discounted medical ACCESS.

Use the Medical Discount Card with an Accident Medical Care plan, and you can afford to get hurt playing Rugby?

Cancer? No.

Rugby? Yes.

Don't you hate it when a coach assumes a guy is good because he has an accent? ;)

Temporary Health Insurance...Made the Playoffs, Huh?

RuckingInsurance.com gets many requests for temporary Health Insurance. Temp HI is a lot like Term Life Insurance, it's inexpensive and lasts for a specific time period.

The reasons for the requests:

1. My Team finally made a playoff round, and there will be an actual official checking for Health Insurance.
2. My Job Situation has changed, and I need to understand all this COBRA crap I'm getting from HR.

This post deals with No. 1:

We love getting calls at 3pm on a Friday asking if we can get you covered for Saturday's match. NOT!!!!

If you've been playing all season without any health insurance, accident/injury plan, or even a medical discount card, you're an asshole. No other way to say it. You've decided to be a burden on society, your team, and your family. Grow up. Rugby is a serious contact sport, and we'll assume you enjoy walking, feeding yourself, and wiping your own ass.

Did you know that hospitals charge more to the uninsured? Did you know that over half of all bankruptcies are caused by unpaid Medical Bills? Do you understand that one of main reasons healthcare is so expensive is that the costs for the uninsured are spread out among the insured?

We can provide $1000 in injury coverage for $9.99 a month (10k for $21.99/mo). So, please don't tell us you can't afford it. If you truly can't afford HI, then quit Rugby and get a job.

If you're worried about a pre-existing, or ongoing, medical condition, don't sweat it. That's what RuckingInsurance.com is for, to find you a plan that suits your needs. A major myth in America is the lack of Health Insurance for Millions. Bullshit. The plans are out there, but because the commissions are so low, or non-existent, most Health Insurance Agents don't bother marketing them. They are bastards.

Now get online, and buy some Health Insurance. Do it now. Or, we will see you in the rucks, and we will stomp on your head, and we will laugh.