Is Ebola Covered Under ACA?

[houcoogster]

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: Compassionate Allowances Website Home Page 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.

Yes Sir York, That is correct! There are different plans to choose from they have evolved over the years and are quite good now. Not as rich as WC but thats the idea....you don't want workers thinking hey if blank happens look at all the gravy I get. Some of the benefits in these policies are secret for that very reason. Texas is the only State that has this....last time I checked. It really is a classic case of the free-market coming up with better solutions than Govt. mandated solutions.

 

[somarco]

Some carriers have tried 24 hour group health insurance in lieu of WC, mostly in TX. They piecemeal a plan together, pairing it with an ADD plan and some form of LOT coverage for 12 - 24 months.

The company I worked for tried to put a program together years ago on a self funded basis (which is the only way it made sense). The problem was the long tail nature of the claim vs stop loss that terminated within 6 months of the end of the contract year. Reinsurers wanted no part of that.

It is much easier to buy a traditional WC plan, maybe with a high deductible, than trying to cobble something together with ancillary lines that will leave gaps.

This is like writing a Mega type indemnity plan and then backfilling with accident, HI, cancer, etc.

 

[houcoogster]

Some carriers have tried 24 hour group health insurance in lieu of WC, mostly in TX. They piecemeal a plan together, pairing it with an ADD plan and some form of LOT coverage for 12 - 24 months.

The company I worked for tried to put a program together years ago on a self funded basis (which is the only way it made sense). The problem was the long tail nature of the claim vs stop loss that terminated within 6 months of the end of the contract year. Reinsurers wanted no part of that.

It is much easier to buy a traditional WC plan, maybe with a high deductible, than trying to cobble something together with ancillary lines that will leave gaps.

This is like writing a Mega type indemnity plan and then backfilling with accident, HI, cancer, etc.

Somarco that is not the case today in Texas there are some Very comprehensive Occupational Accident policies in force here. Might I add at significant discount to WC. I can send you some plan outlines if you would like to look at them. Far far from a mega life policy backfilled with ancillary garbage.

 

[Yagents]

Ebola toolbox: Quarantine benefits | LifeHealthPro

 

[jkinzies]

I do not believe the TX Ebola patient is a US citizen, so he wasn't signed up for Obamacare, so no, Ebola isn't covered in his case. He will receive a bill for his medical services, which I would anticipate will go unpaid, and in that case, then yes, Ebola is covered by increased charges for the insured patients using that hospital.

 

[kgmom219]

I do not believe the TX Ebola patient is a US citizen, so he wasn't signed up for Obamacare, so no, Ebola isn't covered in his case. He will receive a bill for his medical services, which I would anticipate will go unpaid, and in that case, then yes, Ebola is covered by increased charges for the insured patients using that hospital.

1. There is no confirmation either way on citizenship
2. Legal immigrants can get coverage, even without citizenship. Not all coverage in America is on the Exchange (I'm assuming that's what you meant by Obamacare)
3. He has a fiancee. No clue on her citizenship status, but if she is employed and has group coverage, he can be on her policy as a spouse. Texas has the most liberal common law marriage rules in the country. Assuming its not a same sex spouse, all you have to do is put them down on the form. BAM! You have an instant marriage license.

You made a whole lot of assumptions with zero facts to back them up. For all you know, his fiancee works at Texas Instruments (which is about 5 miles from their home), he's on the group plan and TI will picking up the tab after the $300 per person deductible.

In any case, the expense is not the issue. Public health is. I've got schools in my district with kids who are being quarantined. The paramedics in the ambulance are on "house arrest". Their wives and kids will not see them for 21 days. (Any takers on if their paid leave is WC or not?)

 

[AllenChicago]

3. He has a fiancee. No clue on her citizenship status, but if she is employed and has group coverage, he can be on her policy as a spouse. Texas has the most liberal common law marriage rules in the country. Assuming its not a same sex spouse, all you have to do is put them down on the form. BAM! You have an instant marriage license.

KGMom, if Mr. Duncan's USA fiancée added him to her group plan at work, does Texas law make that coverage retroactive to the day he arrived in the USA, even if she signed him up a week or two later?

 

[yorkriver1]

General additions to possible changes in the national daily routine due to Ebola or other pandemics:
Yagents link above to the article on LifeHealth Pro discusses the possible ways quarantine can be reimbursed.
When thinking it through, makes sense, based on the nature of the loss. Short term disability, paid family leave, and so on, or for those out of the country, travel insurance. Not major med policies paying for lost earnings/unforseen living expenses. A couple other arrangements from employers/gov't benefits.

 

[kgmom219]

KGMom, if Mr. Duncan's USA fiancée added him to her group plan at work, does Texas law make that coverage retroactive to the day he arrived in the USA, even if she signed him up a week or two later?

It totally depends...

She has the 31 days from the date of marriage.

So you can conceivably backdate it to before he went to Presby.

Or maybe he was already on the plan when he went to Liberia. And he lives both places.

You can have a group policy and travel.

And TI has PLENTY of employees that are green cards, work permits, legal immigrants, etc. They probably write the laws and give them to DOL to inforce.

My point really was that the poster made all these assumptions and didn't really have a clue what the situation was. Just assumed the guy was an immigrant with no coverage. How the heck does he know?

 

[AllenChicago]

My point really was that the poster made all these assumptions and didn't really have a clue what the situation was. Just assumed the guy was an immigrant with no coverage. How the heck does he know?

Well, it appears that the Honorable Reverend Jesse Jackson, Sr. may pay Mr. Duncan's medical bills. He's in Dallas lamenting over the fact that Eric Duncan is uninsured, and that his treatment is costing approximately $1,000 per hour.

Scolding questioners, the Liberian foreign minister says that this is not the time to discuss who's gonna pay!

Full Story: Hospital bill for Ebola grows at $1,000 an hour in Dallas case | Reading Eagle - AP

It's interesting that the missionaries who returned home last month to be treated for Ebola had group insurance, with a $25,000 deductible. Ouch!

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