United Health Care / DAN coverage

[DA Aquamaster]

Based on my experience you will have to submit a claim to your health insurance provider first, then submit a claim to DAN for the unpaid balance. Also in my experience, DAN also approves or dissapproves certain diagnosis and treatments muhc like any HMO.

In my spouses case she was treated in an ER for a dive related injury (based on the the combined judgement of the ER physician, the hyperbaric physician she consulted with and the person at DAN she spoke with on the phone). Despite that it took 18 months and a threatened complaint to the state's insurance commission to get reimbursed by DAN as the particular diagnosis was not on their approved list.

So DAN insurance is (maybe) worth having, but your primary insurance may be more useful and it may take a long time to get reimbursed in some cases if it is not a textbook example of a dive injury.

 

[miked]

What your medical insurance does NOT cover that DAN does (if medically required):
1. Hotel that you have to stay in for several days or weeks because you can't fly home yet. A dive buddies husband had to hotel it for 2 weeks because he lives at 3,000 feet and could not go home.
2. The cost of the plane ticket at full fare because you lost you super cheap non-transferable, non-changeable ticket because you were bent and could not fly on the appointed day.
3. Air ambulance to fly you home at tree top level if reqyuired
4. Cost of flying a loved one to be with you if medically required (recommended)
5. Cost of shipping you home if the worst happens and you do not survive.
In short, your medical insurance may or may not cover the medical cost (doctor, hospital) of getting bent or other dive related injury, but DAN will pick up the slack and very importantly cover the related cost caused by the dive injury but not directly medical in nature (hotel, air travel, etc).

In short it is cheap and good peace of mind IMHO. I have used DAN in the past and they paid without problem. I have no other insurance, and it was easy dealing with DAN. they paid all the bills without a penny out of my pocket.

I agree with pasley,

I've "Been there done that" for : item 1 ( 3 extra days); item 2; nearly, but thank God, not item 3.
Also: the cost to ship all my gear and almost all our luggage home (Dr said: no lifting/carrying/dragging.....)
Also $400 worth of medical charges not covered by BCBS.{After submitting claims to BCBS}

Total: Approx $3000

The DAN insurance is definitely (IMO) worth it.
take care,
Mike

 

[rigdiver]

No intended insults, but one would be less than smart not to have DAN insurance. I know several people that wish they would have had it. With the price of equipment, vacations, classes----what's a hundred bucks a year? Go for the Master Plan and the Peace of Mind you get with it.
Bill

 

[jduncan]

No intended insults, but one would be less than smart not to have DAN insurance. I know several people that wish they would have had it. With the price of equipment, vacations, classes----what's a hundred bucks a year? Go for the Master Plan and the Peace of Mind you get with it.
Bill

The question was not whether or not to have the insurance. I HAVE IT.

 

[jduncan]

Thanks for the replies. Anyone who has other examples feel free to share. It's nice to know what to expect.

 

[Web Monkey]

I'd get DAN insurance. It's cheap and it works.

The time to find out about policy loopholes is not when you're off diving Someplace Warm and get bent. A chamber ride and the ride to the chamber can be *really* expensive and a lot of locations want to make sure they get paid.

You may end up having to pay for everything yourself and then fight with your insurance company.

Terry

I have a PPO with UHC. I called them today and got a customer service rep to whom I asked "Does UHC cover SCUBA related injuries such as DCI, and related treatments in a hyperbaric chamber?" She put me on hold, and shortly returned saying "If you have a medical condition, we cover it".

I'm curious to know the relation between my normal health insurance, and the DAN coverage I have - over the fact that DAN is "Secondary". How does that work?

I'm interested in hearing from anyone with real life events where they had to deal with both insurance companies after a diving related injury and/or recompression, etc.

j

 

[Diver Lori]

You may end up having to pay for everything yourself and then fight with your insurance company.
Terry

Which is precisely WHY you need to take a credit card with a high limit and no balance with you!

 

[CameronMartz]

FWIW, my wife's employer dropped United Healthcare due to their abysmal reimbursement for "covered" services. I had an ER visit at the in-network hospital where my wife is an employee using her coverage, and we fought for 10 months to get everything covered (as if in an ER you are in a position to preapprove all procedures done to you). In fact, everything but the most basic doctor's visit took many, many phonecalls to get reimbursement during the two years they provided coverage for us.

I know several people who have used DAN, both domestically and abroad, and none has anything but positive things to say about their experiences.

Cameron

 

[ItsBruce]

A bit off topic, but what kind of suit is it that Pasley is wearing in his photo? I recall seeing something like that once, but cannot quite place it.

 

[bobmaggi]

I can personnally say that DAN has been everything they advertise based on my wife's dive accident this last fall. Anything my work insurance did not pick up, we just forward the bill on to DAN and that's all. The only paperwork was included with the first set of bills and it was a fairly simple 2 page form. They even paid off for her dry suit she was wearing at the time that we destroyed!
I have no plans on not carrying DAN from now on (at least as long as I am actively diving), even then I won't equal the amount they have paid so far - still have bill coming in

Bob