Think You're Covered?

[Todd#43]

If you ride a motorcycle, race a motorcycle, ski, snowboard, snowmobile, or take part in any recreational activity, you really need to read this.

If you're not familiar with HIPAA, it basically prohibits employers from denying health care coverage based on pre-existing conditions, or participation in legal activities, like motorcycling. Nice idea, right?

Wrong! When the Department of Health and Human Services released the rules that would govern the act, they recognized that while employers couldn't deny health care coverage based on participation in a legal activity, they could deny paying any benefits. That means that even though you may have paid for insurance, get hurt riding, and payment for your injuries could be denied.

There is currently a bill in Congress (H.R. 1076, "The HIPAA Recreational Injury Technical Correction Act")to fix this problem. Everyone that rides should write their congressman (or congress person) and tell them to support this legislation.

Fortunately, the AMA has set up their Rapid Response Section to make it easy to send a letter, email, etc,

http://www.amadirectlink.com/legisltn/rapidresponse.asp

Thanks!

[gsxrnurse]

HIPPA has been around since 1996. It's not really targeting motorcycle riders like this bill is trying to focus on, it affects anyone with private insurance. Yes, it could affect motorcycle riders but the fact of the matter is that the heath insurance company that you are paying for your coverage can deny your claim for any reason that they want. Insurance companies are highly profitable and actually employ people to look at claims after they have been paid for any reason that they can find to get their money back and make you pay the bill. If you had strep throat and then had your tonsils out, technically you had a pre-existing condition and that gives them a reason to deny your claim. Same thing goes for riding your motorcycle. Just pray that you get fucked up enough if you hurt yourself to qualify for Medicare and SSI.

[Todd#43]

HIPPA has been around since 1996. It's not really targeting motorcycle riders like this bill is trying to focus on, it affects anyone with private insurance. Yes, it could affect motorcycle riders but the fact of the matter is that the heath insurance company that you are paying for your coverage can deny your claim for any reason that they want. Insurance companies are highly profitable and actually employ people to look at claims after they have been paid for any reason that they can find to get their money back and make you pay the bill. If you had strep throat and then had your tonsils out, technically you had a pre-existing condition and that gives them a reason to deny your claim. Same thing goes for riding your motorcycle. Just pray that you get fucked up enough if you hurt yourself to qualify for Medicare and SSI.

Yes, HIPAA has been around since 1996.

If you read the act closely, the pre-existing condition isn't the problem. Its the participation in a legal recreational activity. I understand that an insurance company can deny a claim for any reason, and often times they do. Several years ago my daughter broke her arm. The insurance company covered the ER visit, the ER Doctor, the emergency surgery to place two pins in her arm, but denied the claim to remove the cast, the pins, as well as the follow up visits to the Orthopaedic Surgeon. Why? They didn't think THAT part of it was necessary.

Insurance companies run under their own set of rules anyway. Why not close some of the loopholes?

[gsxrnurse]

I guess I put too many words there. The point is that nothing has really changed within the last 11 years. They didn't add something to it or change anything. It's nothing new to get worked up over. Inciting a panic is not exactly the most responsible way of promoting a situation. It is in fact a GENERAL problem, it does not target motorcyclists or thrill seekers. This article is only showing you half of the information that you need to understand the issue. While I am a fan for the AMA and what they do for motorcyclists, their propaganda is simply that, propaganda. I'm just saying, if you want to fight for a cause, look at the big picture. What I was saying is that if you want to close a loophole, why would you focus on something so small instead of the larger problem.

[Todd#43]

I guess I put too many words there. The point is that nothing has really changed within the last 11 years. They didn't add something to it or change anything. It's nothing new to get worked up over. Inciting a panic is not exactly the most responsible way of promoting a situation. It is in fact a GENERAL problem, it does not target motorcyclists or thrill seekers. This article is only showing you half of the information that you need to understand the issue. While I am a fan for the AMA and what they do for motorcyclists, their propaganda is simply that, propaganda. I'm just saying, if you want to fight for a cause, look at the big picture. What I was saying is that if you want to close a loophole, why would you focus on something so small instead of the larger problem.

I know it hasn't changed, and I know the "rules" have been around since 2001. It was flawed from the start.

I also understand that its just part of a bigger problem. However, this is a "motorcycle related" Forum (just like the AMA is a motorcycle related organization), so focusing on the part that affects the motorcycling community makes sense here.

Obviously, you're in health care. I guess maybe it has broader effect on you personally. For me, denying me benefits based solely on the fact that I was hurt in a legal recreational activity is important. Don't get me wrong, I'd be just as pissed if they denied benefits based on a pre-existing condition. I just thought it made sense to bring it up from a "motorcycling" perspective.

[gsxrnurse]

I understand your point and that people need to be aware that there is a possibility that if you get hurt while participating in recreational activity that your insurance company may deny you. But the propaganda from the AMA source would like everyone to believe that that this is some new law and that you're SOL if you get hurt when the truth is that it's been this way for 11 years with little to no cases of insurance companies denying you based on this type of injury alone. My point is to put this into perspective for everyone who reads this and the perspective needs to be that your likelihood of being denied for getting hurt on your bike is the same as your likelihood to get denied for a pre-existing condition as I stated above. I'm not trying to give you a hard time or say it's an unjust cause, I'm just trying to give everyone the basis to make their own educated decision.

[Todd#43]

I understand your point and that people need to be aware that there is a possibility that if you get hurt while participating in recreational activity that your insurance company may deny you. But the propaganda from the AMA source would like everyone to believe that that this is some new law and that you're SOL if you get hurt when the truth is that it's been this way for 11 years with little to no cases of insurance companies denying you based on this type of injury alone. My point is to put this into perspective for everyone who reads this and the perspective needs to be that your likelihood of being denied for getting hurt on your bike is the same as your likelihood to get denied for a pre-existing condition as I stated above. I'm not trying to give you a hard time or say it's an unjust cause, I'm just trying to give everyone the basis to make their own educated decision.

Yes, its been this way for 11 years, and thanks to groups like the AMA we FINALLY have legislation to close the loophole. Again, I was presenting it from a motorcyclist view on a motorcycling forum. If you read the article in the link, I think most people would get a pretty clear idea of whats going on.

The percentage of claims that have been denied to motorcyclists isn't really important here. Neither is the "likelyhood" that I wouldn't be denied benefits because I choose to ride a motorcycle. What is important is that we have the chance to close a loophole that never should have been there in the first place. Closing one could very easily lead to closing another.

Rights are conceded one at a time. Concede on this, and what's next?