Does anyone have any experience with filing an insurance claim through USA Hockey?

[JR Boucicaut 3772]

Subject says it all -

I'm in a situation in which I need surgery, and my insurance only covers 75%. Looking at USA Hockey, they are a secondary insurance that should pick up the rest of the tab.

Anyone have any experience with that?

In the thread or PM would work.

[JR Boucicaut 3772]

Yeah, I tried but I called when they were closed.

[fastbrother7 0]

Pm ed

[bheidepr 0]

yes. The process wasnt too bad and went something like this:

Get some claim form from local registrar.

Fill it out and you sign and local registrar signs.

Mail it in.

Wait and Wait.

Fill out another form from insurance company on what happended and more on your primary insurance. (I think)

Wait and Wait.

Good Luck.

<_<

[DavidT 11]

yes. The process wasnt too bad and went something like this:

Get some claim form from local registrar.

Fill it out and you sign and local registrar signs.

Mail it in.

Wait and Wait.

Fill out another form from insurance company on what happended and more on your primary insurance. (I think)

Wait and Wait.

Good Luck.

<_<

Pretty much this. The rink coordinator/manager had the form. Fill it out, coordinator signs saying the injury occurred while playing hockey at their rink so on and so forth. Send it in. Wait and wait. Pretty much a huge pain in the ass.

Also, if you dont have an understanding medical field, you may have to pay some or most of your expenses out of pocket until insurance ultimately reimburses you. Luckily most of my doctors showed patience and the insurance came threw, other items I had to pay out of pocket.

[dayroc 0]

Can i ask what happened?

[yrhmblnr8r 69]

Pretty much this. The rink coordinator/manager had the form. Fill it out, coordinator signs saying the injury occurred while playing hockey at their rink so on and so forth. Send it in. Wait and wait. Pretty much a huge pain in the ass.

Also, if you dont have an understanding medical field, you may have to pay some or most of your expenses out of pocket until insurance ultimately reimburses you. Luckily most of my doctors showed patience and the insurance came threw, other items I had to pay out of pocket.

DavidT has it right. I filed a claim after twisting my knee (sprained MCL) but I didn't realize to was a secondary insurance deal so I had to resubmit. As long as you have the signature of the league/rink manager and a witness, they'll come through. It'll just take a while.

[JR Boucicaut 3772]

Can i ask what happened?

Tore labrum in my shoulder.

Pretty much this. The rink coordinator/manager had the form. Fill it out, coordinator signs saying the injury occurred while playing hockey at their rink so on and so forth. Send it in. Wait and wait. Pretty much a huge pain in the ass.

Also, if you dont have an understanding medical field, you may have to pay some or most of your expenses out of pocket until insurance ultimately reimburses you. Luckily most of my doctors showed patience and the insurance came threw, other items I had to pay out of pocket.

I filled out the claim form and according to them I must present it to wherever I have received treatment and tell them it is a secondary form of insurance. REgardless, I'm going to get a second opinion and see a better doctor - going to see the Orlando Magic's doctors.

I am hoping that I would be in a situation that they understand that they will kick in at the end and not hit me up all at once.

[DavidT 11]

Tore labrum in my shoulder.

I filled out the claim form and according to them I must present it to wherever I have received treatment and tell them it is a secondary form of insurance. REgardless, I'm going to get a second opinion and see a better doctor - going to see the Orlando Magic's doctors.

I am hoping that I would be in a situation that they understand that they will kick in at the end and not hit me up all at once.

It may run smoother if it's declared as your secondary. I had to use USA Hockey as my primary insurers as my normal health coverage hadnt began yet.

[nickerjones 8]

That sucks JR , I tore my Labrum in 3 spots playing College baseball. It was Beotch. The problem was , I just took pain pills and kept playing . Now I have a ton of problems with my shoulder popping out when i make wrong movements. I hope everything gets fixed for ya !!

[JR Boucicaut 3772]

It may run smoother if it's declared as your secondary. I had to use USA Hockey as my primary insurers as my normal health coverage hadnt began yet.

Yeah - problem is my primary insurance isn't all that.

As an independent contractor with the Lightning, I have to buy my own insurance. So my deductible is high - so we are hoping it is a case in which my secondary fills in the gaps of the primary, spare $1,000 deductible.

[chippa13 1844]

I don't think you'll be able to get around your deductible using the secondary. They may fill some gaps in coverage or take some of the burden off of the primary but it is doubtful that they will cover a subscriber deductible.

[DavidT 11]

My USA hockey deductible was $3500 for coverage up to I think $50k. My expenses surpassed that, so I had to file a catastrophic claim which had a deductible of $10.5k for coverage up to $125k (I think). I didnt have to pay the $10.5k deductible (only the $3500) as it came out of the first insurance claim that I had with USA Hockey.

[JR Boucicaut 3772]

I don't think you'll be able to get around your deductible using the secondary. They may fill some gaps in coverage or take some of the burden off of the primary but it is doubtful that they will cover a subscriber deductible.

Hmm - if that is the case, fuck that. I'm going to deal with it until I get better insurance.

[tomh7 2]

Be careful with waiting for better insurance. They may exclude it as a pre-existing condition.

[mdamson 0]

I know the process all too well unfortunately. My daughter has torn her ACL twice. First fill out the USA Hockey incident form, have the coach or program director sign it, and send it in to K&K Insurance.

You will not get around the primary insurance deductible. Also, if you go out of plan for your primary insurance, you will be held responsible for a $1000 deductible with the USA hockey insurance. The first charge for the injury must be 30 days after the incident. Thus, you cannot wait around forever then say that you have a condition that was caused by hockey and expect to get reimbursed. You are limited to $25,000 in claims by USA Hockey insurance. There is also a $5000 limit on physical therapy, $2000 for dental, $1000 for chiropractor, and $100 for orthotics.

You can also notify your provider that you have USA Hockey as a secondary insurance, and they will take care of all the billing, or you can collect the bill from the provider, and your primary insurance statement and email them both to the K&K insurance. K&K will then send you a check for the amount that you paid out to the provider.

All claims must be filed within 15 months of the incident, or they will be rejected for untimely filing.

[JR Boucicaut 3772]

Ok - I am at the stage now that they have received my MRI bill but they want proof that I was treated within 30 days, so I have to go to my dr and get that bill.

So, I will have to pay the primary deductible, and then get compensated from USAH after the first $1000 of it?

[frankie56 0]

Ok - I am at the stage now that they have received my MRI bill but they want proof that I was treated within 30 days, so I have to go to my dr and get that bill.

So, I will have to pay the primary deductible, and then get compensated from USAH after the first $1000 of it?

Sorting out primary and secondary insurance can be tricky. Both try to shift the burden to the other.

Your doctor should have a billing office or service. They have the same motivation as you, getting the full amount possible from the insurance company. Most are willing to work with patients.

[sabby47 2]

JR, I worked filing health insurance claims for about a year and also tried using USA Hockey after tearing my ACL.

Your health insurance you currently have will be your primary insurance.

USA Hockey is a supplemental insurance, meaning they should pick up anything after your out of pocket deductible is met ($1000)So technically you have to spend $1000 before they will cover anything. Everything should be billed to your primary insurance first and then the orthopaedic center should send anything left over that your primary didn't pay on to your supplement/secondary(USAH). Let your orthopaedic office know you have the USAH insurance when you go in or call and let them know and a Patient Account Rep should be able to help you out with questions.

The one thing to be wary of with supplemental insurances is that they will do whatever they can to not pay. Keep copies of your forms that you fill out, ask for names when you call and talk with people at the insurance company ect... One of the biggest problems I faced was them saying they never received the forms when I knew I had sent them in at least 2-3 different times.

Hope this helps!

[jmiami 4]

I was injured in a game in April, hit the ER and got fixed up. Then had two follow-up specialist visits in June and July. My primary insurance only covers ER and hospitalization. They do not cover specialist visits, so I had to cough up 450 bucks for those specialist visits. My primary insurance has no deductible though. Someone suggested that USAH could reimburse me for the specialist visits, so I looked into it and filed a claim sometime in August. A couple weeks ago I received a check from them (or actually it was from KK Insurance) for 450 bucks. So no complaints here.

But reading this thread, am I to ascertain that I would not have been reimbursed by USAH if my primary insurance had a deductible of say, 2000 bucks, and my specialist visits had come to 1500 bucks?

[JR Boucicaut 3772]

I just submitted my MRI and two specialist visits. Got a notice from K&K that they were rejected. Have to call them on Monday to see what is going on.

[WBGMike 2]

Tore labrum in my shoulder.

I filled out the claim form and according to them I must present it to wherever I have received treatment and tell them it is a secondary form of insurance. REgardless, I'm going to get a second opinion and see a better doctor - going to see the Orlando Magic's doctors.

I am hoping that I would be in a situation that they understand that they will kick in at the end and not hit me up all at once.

If you see Dr. Shure get a 3rd opinion

[jah713 0]

Sorry to bump an old thread. But I recently hurt my wrist playing hockey. I don't have insurance but I am registered for USA Hockey.

I just began looking up everything that they offer, but I was wondering what they will cover, if anything at all? I plan on waiting a week or so to see how minor the injury is. But I want to have something on the back burner in case something is broken.

[hunterphfr 12]

That sucks JR, sorry to hear that. We've had 3 guys at work go out with torn labrums over the last year and a 1/2. Recovery is bit of a bitch. They were all off work or on light duty for a while before they were cleared to return to work. They say Desjardins may not be healthy until October, having torn his with Norfolk and having surgery.