Accident Care

[Paper1]

I was unfortunate enough to be involved in an accident while riding my bicycle in a roundabout Saturday morning. Person in car stopped and I was transported by ambulance to Villages Hospital. I've got some road rash, bruises, and a broken collar bone. My problem is I have Florida Heart and Vascular and they will not even talk to me as they do not deal with Florida's no fault auto injury insurance. Although I was riding a bicycle my car insurance has to cover my medical care up to a certain amount. So basically I'm sitting home with a broken bone with no one to care for it. I was told my Medicare or Supplemental will not pay anything until my auto insurance kicks in. I got a hold of another orthopedic and they would see if an attorney sends over paperwork. Has anyone gone through this "no fault BS". I'm just astonished my primary care provider will not see me. Thanks for letting me vent.

[kcrazorbackfan]

Ahh, medical insurance; it can be one of the most frustrating things in life that people have to deal with.

Sorry about your accident; think of it as one of life's lessons.

[jnieman]

I found this website with the name of a place in Lady Lake. It has a lot of info on the site if nothing else. I know nothing about them but did a google search and this came up.

Auto Accident Injury Doctor Lady Lake FL | Car Wreck Injury Doctors (https://accidentdoctor.org/florida/lady-lake/)

[graciegirl]

I was unfortunate enough to be involved in an accident while riding my bicycle in a roundabout Saturday morning. Person in car stopped and I was transported by ambulance to Villages Hospital. I've got some road rash, bruises, and a broken collar bone. My problem is I have Florida Heart and Vascular and they will not even talk to me as they do not deal with Florida's no fault auto injury insurance. Although I was riding a bicycle my car insurance has to cover my medical care up to a certain amount. So basically I'm sitting home with a broken bone with no one to care for it. I was told my Medicare or Supplemental will not pay anything until my auto insurance kicks in. I got a hold of another orthopedic and they would see if an attorney sends over paperwork. Has anyone gone through this "no fault BS". I'm just astonished my primary care provider will not see me. Thanks for letting me vent.

I am so sad and angry for you. It is bad enough you are hurt. Wish we could help.

[Bay Kid]

So sad....

[PennBF]

I am sorry you were injured but have a real problem with riders in the circles. There are many ways to avoid this on a bicycle using the paths. It is hard enough for a person driving around the circles without also dealing with a bicycle that can be 3 feet into driving areas. and hidden in the landscape of the circle. There are some who ride bikes and ignore the automobile traffic. In a large category of the bike riders they ignore the traffic laws regulating their use of the roads. Again, I am truly sorry you have injuries but if you ride a bike it is critical to also have some respect for the hazards the auto drivers have and be considerate for their problems to navigate the roads in the villages. The circles being serious hurdles. :ho:

[Carla B]

Yes, I have heard of medical payments getting in the way of injury care as it relates to golf-cart insurance. It led us to cancel the medical payments portion of our golf-cart coverage. I don't know if that can be done with auto insurance or what the consequences would be.

[Boomer]

I was unfortunate enough to be involved in an accident while riding my bicycle in a roundabout Saturday morning. Person in car stopped and I was transported by ambulance to Villages Hospital. I've got some road rash, bruises, and a broken collar bone. My problem is I have Florida Heart and Vascular and they will not even talk to me as they do not deal with Florida's no fault auto injury insurance. Although I was riding a bicycle my car insurance has to cover my medical care up to a certain amount. So basically I'm sitting home with a broken bone with no one to care for it. I was told my Medicare or Supplemental will not pay anything until my auto insurance kicks in. I got a hold of another orthopedic and they would see if an attorney sends over paperwork. Has anyone gone through this "no fault BS". I'm just astonished my primary care provider will not see me. Thanks for letting me vent.


I am so sorry this is happening to you. It is an appalling situation. You need care.

I am providing here a link directly from the Medicare site that gives some details on when Medicare can be billed under the circumstance of no-fault insurance.

(A phone call to Medicare with questions might be in order.)

As we all know, navigating insurance, not just health insurance, can make you feel like you are in a quagmire. It is wise to keep detailed notes on "who, what, when" as you get your information.

What is someone supposed to do about potentially serious injuries while caught up in this web?

Anyway, here is the Medicare link. Click on the next-to-last arrow on the list under the topic "I have Medicare and:"

Which insurance pays first | Medicare.gov (https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/who-pays-first/which-insurance-pays.html)

[SouthOfTheBorder]

I am sorry you were injured. but have a real problem with riders in the circles. There are many ways to avoid this on a bicycle using the paths. It is hard enough for a person driving around the circles without also dealing with a bicycle that can be 3 feet into driving areas. and hidden in the landscape of the circle. There are some who ride bikes and ignore the automobile traffic. In a large category of the bike riders they ignore the traffic laws regulating their use of the roads. Again, I am truly sorry you have injuries but if you ride a bike it is critical to also have some respect for the hazards the auto drivers have and be considerate for their problems to navigate the roads in the villages. The circles being serious hurdles.:ho:

You start out so nicely. :coolsmiley:

Just trying to save you from an unnecessary and unsportsmanlike 'piling on penalty' :)

Don

[GatorFan]

You should have an adjustor who can guide you to services that can help you. If adjustor is not helping then your agent should get involved. If you do not get assistance from them call the department of insurance and they will help.

[Paper1]

I am sorry you were injured but have a real problem with riders in the circles. There are many ways to avoid this on a bicycle using the paths. It is hard enough for a person driving around the circles without also dealing with a bicycle that can be 3 feet into driving areas. and hidden in the landscape of the circle. There are some who ride bikes and ignore the automobile traffic. In a large category of the bike riders they ignore the traffic laws regulating their use of the roads. Again, I am truly sorry you have injuries but if you ride a bike it is critical to also have some respect for the hazards the auto drivers have and be considerate for their problems to navigate the roads in the villages. The circles being serious hurdles. :ho:

I was hoping this would’t turn into a blame the bicycle rider post. That said you need to talk to local law enforcement and write to your congressmen, maybe they will change laws for you.

[Paper1]

I am so sorry this is happening to you. It is an appalling situation. You need care.

I am providing here a link directly from the Medicare site that gives some details on when Medicare can be billed under the circumstance of no-fault insurance.

(A phone call to Medicare with questions might be in order.)

As we all know, navigating insurance, not just health insurance, can make you feel like you are in a quagmire. It is wise to keep detailed notes on "who, what, when" as you get your information.

What is someone supposed to do about potentially serious injuries while caught up in this web?

Anyway, here is the Medicare link. Click on the next-to-last arrow on the list under the topic "I have Medicare and:"

Which insurance pays first | Medicare.gov (https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/who-pays-first/which-insurance-pays.html)
Thank you I will look that up. I still haven’t found an orthopedic yet to treat my collar bone break, but maybe tomorrow

[Marathon Man]

I am sorry you were injured but have a real problem with riders in the circles. There are many ways to avoid this on a bicycle using the paths. It is hard enough for a person driving around the circles without also dealing with a bicycle that can be 3 feet into driving areas. and hidden in the landscape of the circle. There are some who ride bikes and ignore the automobile traffic. In a large category of the bike riders they ignore the traffic laws regulating their use of the roads. Again, I am truly sorry you have injuries but if you ride a bike it is critical to also have some respect for the hazards the auto drivers have and be considerate for their problems to navigate the roads in the villages. The circles being serious hurdles. :ho:

Wow. Talk about kicking someone when they are down.

[graciegirl]

Thank you I will look that up. I still haven’t found an orthopedic yet to treat my collar bone break, but maybe tomorrow

Please keep your arm immobile. It may not be able to be "set" but you don't want it poking your insides.

So sorry you are going through this. Your health insurance won't cover it because it is an accident?

[Paper1]

Thank you for support Gracie. I’m still trying to get an appointment with orthopedic but no luck in day 5. If it wasn’t so unbelievably it would be humorous. I am most disappointed with FHVC whom my primary care doctor works for. They kicked me to curb like an empty beer can when I told them an automobile was involved. They don’t deal with Florida no fault and I kind of understand that but turning down a hurt, existing patient I struggle with.

[jojo]

After you learned of the problem being treated by your physician, did you consider an Urgent Care Center or an Emergency Room?

[Boomer]

Thank you for support Gracie. I’m still trying to get an appointment with orthopedic but no luck in day 5. If it wasn’t so unbelievably it would be humorous. I am most disappointed with FHVC whom my primary care doctor works for. They kicked me to curb like an empty beer can when I told them an automobile was involved. They don’t deal with Florida no fault and I kind of understand that but turning down a hurt, existing patient I struggle with.


After you learned of the problem being treated by your physician, did you consider an Urgent Care Center or an Emergency Room?


jojo, I agree with your comment.


Paper1, you are now a few days after the accident. You know you have a broken bone, and you might be noticing other things about how you feel. Please consider what jojo asked about here.

Also, please go to Google and type in the words that follow: PIP Florida 14 day rule

Doing such a search is easy and will give you a lot of information on what you are facing.

The Medicare link I gave you earlier says that doctors may bill Medicare after 120 days of not being paid by the no-fault coverage. Medicare payment under this situation could be conditional. (You might want to revisit the Medicare link I gave you in my earlier post here.)

(I understand that doctors have bills to pay, too, but what a mess this is, all around. -- This morning on CBS, I saw that there is a teacher shortage in Florida. (probably other places, too) I get that. -- I have been wondering for a while how long it will be before nobody wants to be a doctor. -- But I digress.)

Anyway --

Insurance lobbies are powerful. The law is nuanced. Please educate yourself on what you are tangled in with insurance.

But --

Please, please prioritize taking care of your health.

I wish you well.

[jnieman]

Also have you considered calling a lawyer? If you do maybe they could refer you to an accident injury doctor. I see plenty of these lawyers on T.V.

[Paper1]

An update to let those who responded to my post. I went to Urgentcare 441 today. Had additional X-rays taken and got a referral to an orthopedic. Do not have an appointment in hand yet but encouraged. After my experience I would encourage anyone who reads this to check with their primary care physician and make sure they will take care of you if you are in a car, golf cart, or bicycle accident and fall under Florida’s no fault law. It is a disaster, IMHO.

[John_W]

Let me see if I have this correct. Your health plan wouldn't pay for follow-up care or allow you to see a specialist because they wanted your car insurance to cover those costs because we are a no-fault state? However, you were on a bicycle and not in your car, what if you didn't even own a car or have car insurance?

I don't see how if you were admitted to a medical facility and you show your insurance card, the staff wouldn't handle you. I have the United Health Villages plan and I had no problem seeing specialist. I've been to a pulmonary specialist after I had pneumonia in 2016. I had no problem seeing an iconologist after a cat-scan showed lymphoma spots in 2018. Of course none of these occured while I was involved in an accident, but were outside my normal preventive care provided by TV Medical centers.

[retiredguy123]

I think that something is missing from the premise of this thread. So, a person injured in an auto accident cannot use their regular insurance card to be treated, but, if they are injured in their kitchen, they can get treated? Is that the way it works? I am skeptical about that.

[Paper1]

I think that something is missing from the premise of this thread. So, a person injured in an auto accident cannot use their regular insurance card to be treated, but, if they are injured in their kitchen, they can get treated? Is that the way it works? I am skeptical about that.

I know it sounds bizarre but that is part of no fault Florida insurance. Look at your auto policy and find PIP coverage you are paying for. That is for you. The logic of why my bicycle got involved with my auto coverage escapes me. Again check with your own primary care provider, they may work with no fault. Maybe it is only my primary care? I have Medicare and a UHC supplement but my auto insurance is on hook first regardless of who is at fault. Not sure how they square things.

[Carla B]

As I said in a prior post, the same thing happened to someone involved in a golf-cart accident. When you have an injury the first thing the health provider wants to know is where the injury happened. If it was in your home, fine, Medicare will cover it. If not, then they will look to someone else for coverage before Medicare steps in.