Your private medical coverage and DAN

[littleguppie]

We are doing a 4 day liveaboard in Australia and they are highly rec'd divers insurance specifically to cover 'evacuation' and 'medical expenses'. Well, just joining DAN for $44 gets you the evacuation coverage. Now my question is this...we have private medical insurance through my husbands company. I called DAN and asked why I'd need to purchase more insurance ($25 or $35pp additional) if we have private medical. The rep said I should ask my insurance provider if they would cover 'decompression treatment'. I called my insurance and they said they will cover any/everything that is deemed 'medically necessary'. They said they don't specify everything, but if it's needed, it's covered. The rep for DAN sounded as if it's not common place for an insurance company (we have PPO Blue Cross Blue Shield) to cover scuba diving medical expenses b/c it's a 'dangerous' sport. The BCBS rep told me they don't care or inquire how the accident occured. They just cover the expenses if its a medical necessity.

So, does it sound like I really need to purchase the extra $35pp insurance? Anyone else have private insurance that would cover decompression treatment or has anyone had a problem getting things covered in an emergency?

I know it's only $70, but with this trip costing us a small fortune, I'm trying to save money any way possible. I'm just nervous there is some loophole since the DAN rep made such a big deal about insurance companies not covering scuba diving related accidents.

 

[nereas]

Some dive operations will not even let you join them unless you have DAN.

I have the full preferred plan. Less questions that way.

 

[littleguppie]

No, I plan on joining DAN but am wondering if I should add on the medical coverage (master plan) since we already pay for medical thru my husband's company.

 

[Hoosier]

My medical insurance covers the scuba sport. They don't exclude the scuba as long as it is an individual base. I read through my policy and confirm it with my insurance.

Remember.... DAN is a secondary. It means, when you have a diving accident, DAN doesn't kick in as the primary. Your health insurance covers first and DAN covers the left if there is something that your primary health insurance doesn't cover.

DAN doesn't used to mention this upfront. So, it means IF your health insurance covers the oversea accident and any related expense, such as transportation, DAN doesn't need to kick in your case.

My 2 bar.

Edit: Typo....

 

[pasley]

... I called my insurance and they said they will cover any/everything that is deemed 'medically necessary'. They said they don't specify everything, but if it's needed, it's covered.

A LAYPERSONS Opinion.

Here are some specific questions to ask DAN and your medical insurance if they will pay any or all of the below if medially necessary:
1. The cost of flying in a companion/loved one to stay with you during an extended recovery if the doctor recommends it.
2. The cost of re-booking that non-refundable non-changeable flight because you were unable to leave as scheduled.
3. The cost of a hotel while you sit on shore for a week or 3 recovering before you can get cleared to fly (I know a diver who lives at 3,000 feet elevation and had to stay for 6 weeks in a motel at sea level. Every time he tried to go home, he wound up back in the chamber. I personally took a trip to the chamber 1 week after I was there before when I drove to 1,400 feet elevation. DAN by the way paid 100% as I have no other insurance with no hassle at all).
4. Helicopter evacuation from the boat/dock to the closest medical facility immediately following the injury.
5. Cost of plane with or without medical attendant to fly at low altitude back to the USA if medically necessary.
6. The cost of transportation (ambulance or plane) to take you from the hospital to your home if over 50 miles from home and if medically necessary. This is no longer emergency life threating situation.
7. The cost of returning you remains (should the worst happen) to the USA.
I think DAN will cover the above on their Premium $70 coverage but please ask to be certain. I doubt your own medical insurance would consider any (except possibly Number above 4 Helicopter evacuation) as part of your coverage. I will wager number 6 and 7 would definitely not be covered by your medical insurance.

I believe DAN Premium $70 will cover the above, but read their policy and decide for yourself. DAN I would not dive with out it, and I wold not take a SCUBA Trip without it.

 

[MichaelBaranows]

I know that some medical insurance doesn't cover what they consider dangerous attivates. I have a friend that rides dirt bikes and his medical insurance doesn't cover him if he is injuried when diving motorcross.

 

[Charlie99]

we have PPO Blue Cross Blue Shield

Does your PPO cover 100% of "out of network" expenses?

Many PPO plans cover only 80% or so. As a secondary insurance, DAN would kick in to cover your 20%.

 

[runway1]

... I called my insurance and they said they will cover any/everything that is deemed 'medically necessary'. .... The BCBS rep told me they don't care or inquire how the accident occured. They just cover the expenses if its a medical necessity.

I asked and recieved the same reply from my HealthNet HMO.

... I read through my policy and confirm it with my insurance.

Remember.... DAN is a secondary. It means, when you have a diving accident, DAN doesn't kick in as the primary. Your health insurance covers first and DAN covers the left if there is something that your primary health insurance doesn't cover.

DAN doesn't used to mention this upfront. So, it means that your health insurance covers the oversea accident and any related expense, such as transportation, DAN doesn't need to kick in your case.

Totally agree. I respect DAN and thier service but I think it's insurance overkill if you're covered by a comprehensive and reliable plan

 

[Ken abucs]

I've also read stories where payment was required up front before you took a ride in the chamber. Most chambers see your DAN insurance, and know they'll get paid, no pre-payment required.

I gladly "waste" $70 on DAN insurance every year, but it's up to you to make the decision on what's right for you. Sounds like you already have.

 

[Diver Lori]

I work for THE largest Blue Cross Blue Shield conglomerate in the country and *I* carry DAN insurance, the max. I also take a credit card, with no balance and a very high limit on every dive trip I take out of the country.

Disclaimer: just because the customer service rep told you they would cover anything medically necessary IS NOT A GUARANTEE OF PAYMENT.

'NUF SAID.

If you are still waffling after my post, go back and read posts 5, 7, and 9 again.

And finally, any care you get out of the country, will be reimbursed to you by your carrier AFTER you return to the States and file claims and ONLY what is usual & customary. You will be required to pay for foreign medical care out of your own pocket while in that country.