Is Ebola Covered Under ACA?

[yorkriver1]

Somarco, right on, healthcare workers working with patients and contracting Ebola would be a WC claim in any situation I can imagine.
Not necessarily for those who are not working with Ebola patients as part of their job description. That's where it would have to be evaluated by claims examiners. I'm sure you know that, it was just a thought to make it Google search worthy that it's not a shoe in under all circumstances to get illness covered by WC when maybe contracted somehow during work hours.

 

[somarco]

There are plenty of areas where health insurance carriers and WC carriers play football with a claim, kicking it back and forth until one side finally agree's to pay the claim. Yes, filing a WC claim for Ebola is not a sure bet but I do believe you can make a case for WC if you work in a medical setting.

 

[kgmom219]

I agree that it would be kicked back and forth.

Except in Texas, we are business friendly. We don't require Workers Comp.

 

[somarco]

We don't require Workers Comp

Yes, I made that point earlier.

I also stated that even though a business is not required to have WC does not eliminate the liability a business can incur for OTJ injury or illness.

 

[yorkriver1]

In my state the "not required" on WC is for businesses with under a very small # of employees. Owners mistake that as "I don't need to buy it, because the law doesn't apply to me, and I have adjusted the # of employees I have in order to avoid buying it."
At an event with agents, one told a story of a client who did just that. Client's friend who worked for him was told "on a handshake" the owner would "take care of him" if there was an injury. Apparently, the story goes, he didn't have that agreement with the employee's spouse. The employee was seriously injured on the job. She filed with the state comp commission for a WC claim and eventually, the owner, taken to court, had to pay for the amount of benefits as if there had been WC in place, had to sell the house, and more. There was a large sum of money owed for treatment and loss of income. Medical expenses are unlimited on WC.
Free to make an informed choice, voters can put that in place. Unfortunately, many don't understand the choice they are making.
Mic drop.

 

[kgmom219]

I totally agree that not having WC is stupid and leaves a company wide open.

Pre ACA, the carriers would max load a business without WC

 

[houcoogster]

I totally agree that not having WC is stupid and leaves a company wide open.

Pre ACA, the carriers would max load a business without WC

We have comp alternative which is actually a better program than WC.. Cheaper and not as easily to manipulate.

 

[allanreich]

Yet its not decided that whether Ebola will be covered under ACA or not. According to experts, the treatment of Ebola is a long term process and Standard insurance plans do not include long-term care coverage. We should wait more to know what would be White House's decision on this.

 

[somarco]

York, the minimum # of employees where WC is required in GA is 3. If you have 1 or 2 employees WC is not mandated. Too often it is interpreted as "We don't need to buy it". This is further amplified by health insurance policies that include 24 hour coverage if you are not covered by WC.

Even if your health insurance covers OTJ injury/illness it won't provide LOT benefits or a death benefit.

Standard insurance plans do not include long-term care coverage.

If you are referring to the traditional (insurance) definition of long term care (home health for example) there is some truth to that. WC has similar limitations.

We should wait more to know what would be White House's decision on this.

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York, the minimum # of employees where WC is required in GA is 3. If you have 1 or 2 employees WC is not mandated. Too often it is interpreted as "We don't need to buy it". This is further amplified by health insurance policies that include 24 hour coverage if you are not covered by WC.

Even if your health insurance covers OTJ injury/illness it won't provide LOT benefits or a death benefit.

Standard insurance plans do not include long-term care coverage.

If you are referring to the traditional (insurance) definition of long term care (home health for example) there is some truth to that. WC has similar limitations.

We should wait more to know what would be White House's decision on this.

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[yorkriver1]

1. Houcoogster, is this what you are talking about as a WC alternative? I encountered a worker on a 1099 arrangement, with a contract that specified contractors must carry "occupational accident insurance". This policy is paying a monthly disability benefit for a work related injury. I looked up "occupational accident insurance" and the reference I found states it also pays for medical expenses and income for the family if the worker dies. Sounds similar to WC benefits. I assume an employer could purchase this kind of insurance for payroll employees. I don't know exactly why the firm that the client was contracting with required 1099 contractors to carry occupational accident coverage, lawsuits, maybe? But it certainly is a win-win, because otherwise there would be no help for them other than applying for SSDI, if seriously hurt. The policy is a 2 year benefit, which, I guess, also gives them time to apply for SSDI for a longer disability. The 2 year limit would make this not quite a WC equivalent in situations where by law the employer is "on the hook" with or without insurance.
2. allenreich, welcome to the Forum! I am just thinking, there are no immediate mandatory LTC coverages for any illnesses I know of, other than under the WC state laws, or for veterans. There are provisions under SSDI for a fast track decision, and Ebola could possibly be added to the list: www.socialsecurity.gov/compassionateallowances The statement from Social Security is that some illnesses are so severe and obviously qualify for benefits, they can be processed in a matter of days. My husband and I helped one of his friends to apply, and it was fast, although with the usual need to get more paperwork, stay "on it", visit the local office, but all in all not too stressful. There is a list of about 50 conditions, and I suppose Ebola could be added, if it produces an inability to work while recovering.
You mention it is not determined whether Ebola is covered under ACA. The medical part is, and it's also notable that LTC is not covered under major medical insurance whether ACA or not. It's not covered under Medicare either. LTC is it's own category, which could possibly be covered under SSDI, or for someone with low income, by Medicaid. There is an LTC forum, for LTC insurance. Anyone with assets to protect is a possible candidate to purchase LTC, or one of the newer life or annuity policies with LTC rider.