UKC

Heading out on a bouldering trip soon to the US.

Was thinking of topping up my AAC insurance with but the single trip top up with KNOX via the AAC, but it only covers upto 500,000 euro medical. 

Does that just too low for the US? Snowcard gives 10million. 

I tempted in this case to go belts and braces.

Cheers 

Mark

I have had the same dilemma a number of times. In the end decided the Knox upgrade was insufficient for USA and got cover from Sportscoverdirect.com because for me, being elderly, the age loading of BMC and Snowcard premiums is outrageous.

Sprtscover are good to deal with when buying. I have no experience of their efficiency when claiming.

It depends on what you think will happen and your risk aversion but  you will probably want more.

Prices in US hospitals are very high for many reasons, but one that will relate to what your costs may be in an incident is that the health insurance companies always negotiate a lower price within their network.

For example, I recently had a bad ankle sprain that I couldn't walk on so I went to the ER as I thought it might be broken. I was only there for an hour, an x-ray and medical "services" (giving me a bandage and crutch) and a couple of minutes with a doctor the prices my bill came to $1500 (that my insurance paid most of), however the price before the insurance company discount was ~$25,000.

I can imagine if you had a bad accident where you were hospitalized for a couple of weeks, you could easily rack up a huge bill in excess of $500,000 if your insurance company does not negotiate a price with the hospital you would be going to, (much more likely with travel insurance). 

Now a bad accident like this may be unlikely bouldering, but anything could happen, car crash etc.

If you're planning on doing anything highball etc, or anywhere where you could take a big fall then I would definitely get more.

If you do end up going to a hospital, don't let them give you anything that you can get from a pharmacy unless you can confirm that it's not going on your bill. I've heard stories of hospitals charging insane amounts for things like ibuprofen. 

Where are you going?

Bishop, Vegas and Joes Valley.

Thanks for the info guys

Cheers 

I’ve headed out the the states atleast once a year for the past 5 years to climb and adventure as much as possible. I use a company called sports cover direct, you tick off all the activities that you intend to do (each are categorised due to risk factors) and they insure you to the most dangerous category and all categories below. It did get quite high after ticking off ice climbing.

On last April’s trip I managed to get severe snow blindness which took me to the ER three times, all the medical costs were covered.

Fairly typical - one of our uninsured patients had a trip to the ER recently - $20k for a head CT, chest X-ray and a poke from an ER doc. In there about 4 hours. What would the hospital have got if they were insured? About $1200. Needless to say, the patient wouldn't even be able to afford the latter. 

The US medical system is pretty close to the mafia - so you are best off being armed to the teeth when dealing with them. 

Those costs sound completely outrageous before you apply your insurance company 'discount'.  Is this set up so that unless you use your insurers preferred hospital they just pluck an figure out of thin air?

I don't suppose either of you still have the bill to see how they tried to charge tens of thousands of dollars for their care?  Figures are freely available online for the approximate costs of NHS services to compare.  If I recall correctly:

An ED visit costs roughly £80-120 depending how badly you're broken

A plain film X-Ray costs about £25

A tubigrip costs about £2

Some painkillers for a few pence

Some crutches for a tenner

If you need a CT that's about £100

Add on an ECG and some routine bloods is another £20

Even if you have to also add on nurses and doctors time for another couple of hundred quid for a few hours I struggle to see how you get over $1000, let alone $25,000.  In a completely private system would you not expect competition to drive the costs down to attract insurers to your hospital?

I've heard about an idea that NHS patients leaving hospital could be given a hypothetical bill - of what their healthcare would have cost under a private system.  It would certainly raise some awareness if you were told after leaving A&E that you have just had £500 of free healthcare (or $30,000 if you were an uninsured American).  Given that one hospital I have worked in had a shiny new computer system to log every aspect of the patient's treatment (along with tabs to fill in their health insurance details) it wouldn't be too hard to facilitate!

I notice that the average family healthcare plan in the US costs over $800 a month, with an average of excess of nearly $8,000.  I wasn't aware of this and I wonder how many other were?

edit - sorry I know this is a bit off topic but I find it interesting!

These costs are typical for US healthcare. Here's a bill of $55k that someone posted after having their appendix out.

https://imgur.com/a/WIfeN

It's hugely expensive, and why you have to pay extra to include the US in any travel insurance package. For all the things you hear about the NHS being inefficient and wasteful, the actual costs of most things are depressed by set tariffs and the size of the organisation. 

In the UK people are mostly insulated from experiencing the real cost of healthcare.  I've seen a bill for over £10k for someone that fainted in a European country.

Yes, fortunately for me the insurance companies I have been with through my employers are always big and most places are in Network.

I can check later but my most recent was something like $500 for x-ray, $500 for ER Services, $500 for ER Doctor. But it doesn't break down more than that, or the pre-discount cost.

On the other hand seeing a GP costs me nothing after my deductible (excess) is met, and I can nearly always get an appointment when I want it. It's about $125 before the deductible.

The bargaining power of the insurance company drives the costs down for those insured. They usually want to be in a Network because the volume of customers (patients) will be much higher. They know they would never get that much from an insurance company so they set the prices quite high. However, even through my employer I pay $79 each pay packet (2 weeks) for my insurance. Without the group policy it would cost hundreds a month.

Sounds like a good idea. Most private systems aren't as bad (in terms of cost) as the US though, but I would say the NHS is probably better than most (when it's not being systematically destroyed to try and convince people that private is better).

It's insane if you don't have a good policy through your employer. My wife get's hers through university and I get mine through work. My annual excess is $1500 but my employer puts $750 a year into a a Health Saving's account for me, and I'm covered 100% after the excess. My wife's coverage after excess depends on what the issue is, it varies from 80% to 100%. But to have her on my policy would cost a lot more.

Hope that helps.

I spent some time in America and was also confused to discover that the bill the insurance company paid was much lower than that presented and that they had haggled a 75% discount.

I had a exploratory knee surgery where they stuck a camera in and then an actual op, both as a day patient and then some physio. The bill was for $80,000. The insurance company paid a quarter of that. 

If you are not insured then you get gouged. The true price must surely be the one they settle for with the insurance company and not the vastly inflated one they bill.

It was quite alarming how many crowd funding accident funds went round for uninsured climbers who had had accidents and were being screwed. First for rescue costs and then for insane medical bills!

?????