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Would you recommend extra insurance if I am instructing in the US coming from Australia?

post #1 of 19
Thread Starter 

I am going to be teaching in CO this coming ski season and am wondering what other Australian's in the same situation do about insurance.  I am aware I need regular travel insurance while I am not teaching. However I would want to know that I am fully covered while teaching.  I have read through the insurance offered by the company however I think if I did have an accident the amount covered didn't seem quite right with what I know the medical system in the states to be.

Would love any help on this topic.

Wondering if my insurance would have to be US seeing as I am employed by the US.

post #2 of 19

Some insurance is more insuring than other insurance. First you have to consider what you are getting insured for (e.g. travel, liability, health). Travel insurance insures you for travel costs. According to my understanding whether you are teaching or not has no impact on your travel insurance. Once you are in the US, travel insurance should only cover expenses related to travelling back home (e.g. if you got injured  or sick and out for the season and needed to change your flight home and that cost extra $$). Liability insurance can be useful if one of your students gets hurt while you are teaching. Most US instructors rely on their employers for this insurance. But there is a small chance that an instructor could be held personally liable, so a very small number of instructors get insured because they have personal assets that are worth going after (I don't know anyone who does, but I've seen ads selling this). Most instructors in the US who buy personal liability insurance buy it because they teach in "informal" situations (e.g. camps/clinics). Health insurance comes in two flavors: workers' compensation and regular insurance. Workers' comp only covers accidents that occur while working, but it covers health costs and wage replacement costs. Workers' comp is paid for by the employer. Workers' comp coverage typically requires you to go to specific health care providers. Many instructors don't care about the wage replacement aspect of workers' comp and don't want the hassle of using a health care provider who is not their regular doctor. In those cases, they just use their regular health insurance. In the past, most ski instructors got their regular insurance from their "real" "other" job. If one did not have another it was easy to get covered for everything but pre-existing conditions, but expensive to get insurance "on your own". Now, under the affordable care act (aka ObamaCare), it is easy to get covered for everything, but the paperwork/process is typically a pain. At least the costs for ObamaCare are lower and in many case they are subsidized. Some temporary immigrants may want to take advantage of ObamaCare while they are in the US (check here for eligibility). Some may want to just use their own insurance from their home country. Blue Cross/Blue Shield is widely accepted in the US and is globally available.

 

Some places "take" only certain kinds of health insurance. That means they will only bill you for the portions of their bill that are not covered by insurance (e.g. the copay). If you don't have insurance from companies they "like", then you have to pay the full bill and then get reimbursed by your insurance company. In that case if there is any argument about what expenses are "reasonable", you get to be in the middle of the argument. Some kinds of health insurance have "in network" and "out of network" providers. If the provider you choose in is not "in network", then your expenses are typically higher and the paperwork may be greater. Some insurance companies provide coverage for when you travel out of your home country. You may be covered in the US under health insurance acquired in Australia. Even if you are, it may still be a benefit to acquire additional coverage here.

 

Deciding what option is right for you is part of the "joy" of the process. Some people might even call it a "blessing". Others might call it things we can't politely say. Hope this helps.

post #3 of 19

As a tourist from British Columbia my provincial government health insurance offers some, but limited coverage in the rest of Canada and no coverage in the USA. So I buy additional private health insurance for about $350CDN/year it includes paying to have someone drive my truck home for me if I am unable to do so.

 

A few years ago I had an injury claim while on a ski trip to the US. I did not pay out of pocket for a doctor's visit or the the Ultra-sound referral although I think that was mainly due to the US doctor clinic not billing me but instead billing my insurance company. The reason I think this is that I kept getting requests from the insurance company, once I got home, to start a claim file even though I had  nothing to claim.

post #4 of 19

^The Rusty

 

I think you might misunderstand the concept of travel insurance as used in rest of the world.  I can only speak directly for European Travel Insurance but I believe Australian is similar.  The primary purpose of a travel insurance policy (from my perspective) is to cover for medical emergency costs and repatriation when travelling.  Stuff like baggage/posessions cover and airline bankruptcy and other stuff is nice to have but not the primary reason I take it out. 3rd party liability is another reason to have it particularly in the US.

 

 

To the OP I'd say understand the Worker's Comp law when considering how much you are covered for when working and ensure that your personal travel insurance policy covers you for all the time when you'll be skiing off the clock (lots of Euro policies are very fussy about no of days you can ski & also whether they are leisure only policies)

 

 

Additional question because it's curious to me - why am I able to take out a travel insurance policy with high medical coverage ($10m+) with low co-pay that covers me for extended stays in the US at significantly less than a US domestic health insurance plan.  I guess the logic is that is something long-term or chronic happens they'll repatriate me at the earliest medically feasible opportunity so limit the true downside.  But obviously they'd be on the hook for full ICU type treatment. 

post #5 of 19

FatBob,

 

Yes. Thanks. I was unaware of the medical coverage. Despite references to "Emergency medical coverage" I see policies that cover "If, while on a Trip, an Insured suffers an Injury or Sickness that requires him or her to be treated by a Physician, ". That sounds like coverage for anything that is not preventative. Of course, the particular policy I'm looking at has some (cough) "general exclusion" loopholes:

 

Quote:

participation in professional athletic events, motor sport or motor racing, including training or practice for the same;

..

The ascent or descent of a mountain requiring the use of specialized equipment, including but not limited to pick-axes, anchors, bolts, crampons, carabineers and lead or top-rope anchoring equipment; 

 

if the Insured’s tickets do not contain specific travel dates (open tickets); 

One could argue that the first two don't apply to skiing or ski teaching. Then again, have you ever had a positive experience arguing with a travel insurance company? If travel insurance is significantly cheaper than normal health insurance it's a safe bet that you aren't getting the same coverage.

post #6 of 19

Regarding workman's comp, you need to understand your employer's policies as well.  Vail Resorts takes the position that workman's comp covers you only while you are "on the clock."  So, if you slip and fall while walking from the locker room to lineup, you are not covered.  Similarly, if you are transiting (skiing to lineup), even if in uniform, you aren't covered.  So, don't rely too much on workman's comp -- it may cover you, but there are a lot of situations where you can be injured and need medical attention that will not be covered.  In addition, these gaps in coverage create a lot of incentives for your insurance companies to fight over who gets left with the bill.  

 

It's important, therefore, for you to carefully assess under what circumstances the various policies will provide coverage and won't.  I'd check the travel insurance to be sure it provides coverage even when you are working.  If you have to buy a US policy, then understanding what it will and won't cover will also be important (and mind boggling).  For example, many (most?) policies cover treatment only at "in-network" providers (sometimes with the exception for emergencies -- I had a dispute with my insurance company when they didn't want to cover the cost of putting my dislocated shoulder back in place because the medical clinic at Aspen-Snowmass was not "in-network").

 

Sorry our health care system is so complicated.  It is part of why the cost of our healthcare is expensive.

 

Mike

post #7 of 19
There's also "temporary" insurance that is not purchased through healthcare.gov and does not meet the Obamacare requirements. For my daughter, who was rejected for Obamacare because her income was too low, but rejected by Medicaid in Montana because her assets are too high, it was the only solution. She has the "permission to not have insurance" letter from the Feds, but is still insured. It also happened to be cheaper than standard policies.

Hopefully she'll find a job soon...
post #8 of 19
Quote:
Then again, have you ever had a positive experience arguing with a travel insurance company? If travel insurance is significantly cheaper than normal health insurance it's a safe bet that you aren't getting the same coverage.

Yep plenty. Saved me a $1000 bill when I put new ski edges through the bridge of my nose walking across a slippy parking lot. Repatriated me from Bolivia and provided private ambulance to the best shoulder surgeon google could find when I smashed a scapula mountain biking. Repatriated me first class from SLC when I fractured tib plateau at Snowbasin ( admittedly that was more of a hassle finding a hospital that were prepared to bill straight to insurance in the Ogden area) and I could still drive as fracture wasn't identified until subsequent MRI.
post #9 of 19
Another person with very positive experience with travel insurance. Then again, I bought the top package, wincing. It turned out to be a bargain. Recovered all my medical, new air tickets, cancelled hotels, additional meals and lodging, additional rental car, etc. About $12000 worth of reimbursement for a $381 investment. Plus I was able to turn down the CDW on the rental car before all that happened (was outside the US).
post #10 of 19

I will concede that there are many people with positive experiences with travel insurance. My point was the predominance of negative experiences when needing to argue with a travel insurance company. There are many stories where the insurance companies use the twin tactics of excessive delay in responding and and excessive requests for additional documentation. Like Donald Trump, I'm sure there are some very nice travel insurance companies.

 

The bottom line here is that cjn33 needs to check the fine print on the travel insurance first to determine if or how much extra insurance should be purchased. It sounds like it could be possible that purchasing a definite return trip date might let travel insurance do a pretty good job as a substitute for health insurance. It would really suck though to tear an ACL free skiing in uniform, not be covered by workers comp and then have the travel insurance company say it was practice for professional sports on a lift served mountain and therefore not covered. Then one would need to start arguing.

post #11 of 19
My biggest problem with the claim process was no staples or paperclips were allowed. Consequently, they theoretically get this huge sheaf of paper and can't make head not tail of it. Because much of my documentation was in German, we had some go rounds about me not having furnished something. But, I had, and had furnished it in both languages. And, to make up for lack of paperclips, it was in envelopes (ha, gotcha). So ultimately, they couldn't say they didn't have it, couldn't understand it, etc. The part that really frosted me was that they'd issue a check, not say what it was for, then not explain why it didn't equal my number. I swear the goal is to wear you down. But, after four checks, I was happy. Unlike my experience with United Healthcare here in the states.
post #12 of 19

Oooo - I had a doctor fire me as a patient because my employer switched to United Healthcare.

post #13 of 19
I think some of the companies routinely deny claims at the onset hoping that people will not pursue the claims. There are many exclusions in some of the policies I have read. You have to be persistent as Sib said.

If you are injured while working and your claim is denied, there are administrative procedures to pursue claims. Colorado is a fairly liberal state when it comes to Workers' Compensation benefits.
post #14 of 19
Here in the US state regulatory agencies not the federal government sets the rules for insurances in their state. Oddly enough I am an insurance agent here in CO and my new wife is from Perth. She strongly suggests travel insurance. Her carrier was Amie and along with the your socialized medical insurance from the Aussie government and any existing private coverage you should be fine. Although I would contact your private carrier to make absolutely sure.

As far as comp here in CO. It would cover on the clock injuries, including walking to line up and to the locker room after a lesson but still in uniform. Once you check out for the day Off the Clock falls would be covered under their property and casualty policy while walking through the base area, or in their on the hill buildings. On the hill skiing would not but Amie would kick in for minor things and cover urgent and emergency care plus repatriate you for major things if needed after emergency care.
If you like, call Steph and me to discuss this further. I will pm you that number if you like.
Edited by justanotherskipro - 9/19/15 at 8:24am
post #15 of 19
Actually, WC covers parking lot falls when you arrive or leaving work even before you clock in or after you clock out.
post #16 of 19
That is partially true, if you stop to shop, or get something to eat / drink prior to arriving, or leaving, the rules change. P&C covers that like it would for homeowners. Even so it gets complicated and liability cases get long and drawn out. Amie would cover those incidents anyway and might be a faster claim process.
post #17 of 19
Quote:
Originally Posted by justanotherskipro View Post

That is partially true, if you stop to shop, or get something to eat / drink prior to arriving, or leaving, the rules change. P&C covers that like it would for homeowners. Even so it gets complicated and liability cases get long and drawn out. Amie would cover those incidents anyway and might be a faster claim process.

There is a plethora of case law that provides WC coverage for a reasonable period before and after work. There is also personal comfort doctrine which extends WC coverage for breaks etc. I think people would be surprised to see what kinds of things are found compensable injuries. WC hearings are not liabilty cases and hearings are held within 3 months of the application. If compensability and medical benefits are denied, there is a procedure for expedited hearings.
post #18 of 19
As an attorney in Colorado that makes sense but from an average joe perspective the travel insurance would pay much sooner than three months (in Steph's case she had no out of pocket expenses when she got injured) and he would need that coverage for any regular medical (illness) issues anyway.

Stiil it would be great if you would outline some of those lesser known comp coverages.
Edited by justanotherskipro - 9/19/15 at 12:35pm
post #19 of 19
Quote:
Originally Posted by justanotherskipro View Post

As an attorney in Colorado that makes sense but from an average joe perspective the travel insurance would pay much sooner than three months (in Steph's case she had no out of pocket when she got injured) and he would need that coverage for any regular medical (illness) issues anyway.

 

I agree that it makes sense for her to purchase a policy like that for situations that are not covered.  WC in Colorado is very confusing to people who are not involved in the systems and there are a lot of misconceptions about what it does and does not cover. I am sure that you, as an insurance agent, would want to have the correct facts.

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