UnitedHealthcare refused to pay for rehab and transport for Idaho man paralyzed in Switzerland, his family says

[Northeast Agent]

UnitedHealthcare refused to pay for rehab and transport for Idaho man paralyzed in Switzerland, his family says

He was life-flighted to Bern but still needs to travel back to the U.S. — but he already owes hundreds of thousands in medical bills

www.yahoo.com

The story doesn't say if he has an individual or a group UHC insurance plan, but he should have bought a foreign travel policy.

Stetson told The Independent that a third-party administrator told his brother that it "wouldn't be medically necessary to move him to the U.S. to get care" and that the healthcare company wouldn't pay foreign claims. He says they have not received a denial in writing. So, the family has been "working under the assumption that [his rehab and transport] are not going to be paid."

 

[LeeV]

Sad story and I feel for them, but a few things stood out in the story. The first is what Northeast Agent said, he should have had foreign travel coverage and also medical evacuation.

The second issue I see is the third-party administrator advice. A TPA is used primarily for self-funded medical plans. If this is true, then the plan sponsor (employer) calls the shots.

 

[somarco]

I am interested in knowing the verbiage in the UHC policy regarding foreign travel medical claims.

It does not appear that UHC is liable for the air transport, medical claims or travel & repatriation back to the USA.

While it may be true the man could get "better care" in the USA it does not seem the transport is a matter of medical necessity.

Switzerland is party to the schengen visa which requires proof of valid travel insurance.

And what's up with the last few paragraphs about the murder of former CEO Thompson? How is that relevant to this claim?