Whether you are on the local rugby team or like boxing as a workout, activities such as these can keep you fit and healthy in a fun way. That is unless you hurt yourself and have to go to the hospital. The reality is that anyone who participates in sports is going to be susceptible to injury.
While most sport-related injuries tend to be relatively minor, some can cause more serious problems, especially without proper treatment. This Pacific Prime article answers the question: does health insurance cover sports injury?
Are Sports Injuries Covered by Health Insurance?
You may think that your health insurance policy will have you covered from the unexpected, but the reality is that sports and high-risk activity-related injuries often come with severe limitations.
While some people opt not to exercise at all, many others prefer to stay active by visiting parks, going to the gym, or participating in sports to stay fit. However, it is important to remember that as we age our physical chemistry changes and we become more injury prone.
To give you an idea of just how expensive a sports injury can be, a Beijing rugby club player was injured during a rugby game, leaving him with medical bills totaling RMB 30,000. Unfortunately, his insurance only covered up to RMB 10,000.
In the end, he had to come up with the rest of the money to be able to get the surgery. To try and help ease the costs, which is a substantial amount to pay out of pocket, the rugby club also organized donations to raise money for the player.
Sadly, this is not the first or the last time a situation like this will occur. That’s why it’s imperative to know the ins and outs of your health insurance policy.
Understanding Your Health Insurance Policy
Whether you have an employer-provided health insurance plan or your own health insurance, it is important to understand your policy’s details like exclusions and terms and conditions. Carefully compare your options and ensure that the plan you have covers the activities and hobbies you’re into.
Exclusions
It is vital that you read the fine print to understand what your policy does and does not cover or, as we say in insurance, what your coverage includes and excludes. What your plan does not cover is called an exclusion, which can include certain treatments, surgeries, and medicines.
Different plans have different exclusions, even when they’re from the same insurer. For example, injuries sustained whilst playing sports at a professional or competitive sport (i.e. where money is involved) are generally excluded.
If you wish to be insured as a professional athlete, you will need specialized insurance. On the other hand, sports for leisure (unless considered a dangerous or extreme sport) are usually covered.
To find out whether certain sports injuries, such as rugby, are included or excluded in your policy, you’ll have to look at the exclusions list provided on the table of benefits. Or you can call your insurance broker or provider if you have any questions concerning your policy.
Terms and Conditions
As with any product you purchase, there are various terms and conditions in regard to health insurance, especially concerning sports injuries. Extreme sports, high-risk activities, and high contact sports are usually not covered by health insurance policies.
That means any injuries sustained from sports and activities such as rugby, rock climbing, bungee jumping, and skydiving are rarely covered. Your insurer may cover you if you sprain your ankle while playing football as a hobby, but reject your claim if the injury happened while rock climbing.
With that said, some insurance providers do not differentiate between activities and can cover dangerous sports, professional athletes but impose restrictions for contact sports like rugby – even at an amateur level.
Make Sure Your Coverage Suits Your Needs
Most people often believe that their insurance plan will cover all their injuries, only to find out that there are restrictions and/or limitations when they try to claim for them. That is why it is important to make sure that your plan covers the activities you enjoy.
It’s worth mentioning that serious sports injuries may involve more than a quick surgery or treatment. To make a full recovery often requires physical rehabilitation. In these cases, you will need long-term benefits to be covered.
That’s why those that often engage in sports should look for an insurance plan that has both inpatient and outpatient coverage. It’s also important to ensure that benefit limits are sufficient in the event of a worst-case scenario so that you never have to pay out of pocket.
Make sure that your plan covers everything you might need (to a reasonable degree) so that in the case of an injury, you won’t have to worry about the financial strain. By securing a health insurance plan that covers your needs, you can enjoy the sports you love knowing that you are protected.
Put Your Health First With Pacific Prime
Now that you know more about sports injuries and health insurance, it’s time to review your existing policy or secure an entirely new one. If you’re looking for a health insurance plan, then look no further than Pacific Prime.
As an experienced insurance intermediary, we can help you find the right plan for your needs and budget. Contact us today to learn more about your insurance options.
Disclaimer: Pacific Prime solely represents, operates and manages locally regulated insurance products and services in the territory of PR China. Any references to Pacific Prime Global Company or Group, the international services, insurance products or otherwise stated written or verbally, is for introduction purposes about our overseas network only as each entity is fully independent.