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Workers Comp, BC/BS and Medicare
#11
https://www.healthcare.gov/coverage/pre-...onditions/

The above has information about pre-existing conditions. Grandfathered policies ended on 2014. Unless you purchase private insurance outside of the enrollment period they should cover pre-existing conditions.

"All Marketplace plans must cover treatment for pre-existing medical conditions.
•No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.
•Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health."


So how does this affect an injured worker that sold the medical ?

Is this specific clause that you have posted legally binding on a private insurance companies reimbursement and subrogation rights ?

What you have posted could lead an Injured Worker to believe their work related injury or illness is still covered regardless of releasing future medical.

No one disputes the ACA covers pre existing conditions. How does this relate to to the original question.

The original poster asked if another would accept liability after the medical is sold out for a knee injury.

The answer is no !

Just call the private insurer and explain you have this work injury , sold the medical and now want them to pay for care .. no problem right?

Just let the treater know that you have this work injury and are now billing private insurance , you sold the medical... no problem right ?

Cite the affordable care act if you get a denial for a preexisting condition with an existing or preexisting liability Smile

The ACA 's pre existing condition clause and an insurers right to recovery are two completely different issues.

Injured Workers beware of this misinformation. Sell your medical ..you're in a really bad place if you need medical care. You are not covered.

No one can provide a health insurance policy that accepts liability for a workers comp claimant that sold their medical ... no one ..ever !!

Please post it Smile
 
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Messages In This Thread
RE: Workers Comp, BC/BS and Medicare - Shadow - 03-05-2018, 11:16 PM

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