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Workers Comp, BC/BS and Medicare
#4
I think it is a safe bet to say Blue Shield/ Blue Cross will absolutely not cover a work related injury without reserving their reimbursement and subrogation rights. This is in the Evidence of Coverage within the insurance contract.

BC/BS insures the husband. Maybe the wife? Not the wife's work injury?Every private insurance contract I have ever seen specifically excludes injuries or illnesses that arose out of the course of employmet.

Medicare will absolutely not cover a work injury without a MSA in place .First thing Medicare is going to do is list the comp carrier as the Primary Insurance.

Absent the knee surgery would the arthritis be present? Surgery actually speeds up the process. Would a replacement be needed? No one here can give medical advice to your question.

Since you are a NCM she must have an open medical correct ? If she has an open medical it's on comp . If she sold the medical its on her.

I think its impossible to shift a work injury in to private insurance..Actually I challenge anyone to show me a ( proof positive ) case where they did, legally of course, within the contracts / medical insurance provisions.

I was taught that no insurance company will accept liability for a loss that another insurance company holds liability for.

Please take good care of your injured worker. She will need your help as a Health Care Provider post Worker Comp financed knee replacement.

Just my opinion here . If I am wrong , I take full responsibility. I am just another injured worker too.

Without the state its hard to say ?

Looks like you are in New York?

Good Luck
 
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RE: Workers Comp, BC/BS and Medicare - Shadow - 02-20-2018, 03:59 AM

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