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| Do Individual Health Insurance Plans cover on the Job Injuries? |
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| Let's take a look at the typical exclusion for Worker's Compensation - |
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Exclusions and Limitations
Amounts in excess of customary and reasonable charges for care rendered by a non-participating provider without a referral from your PMG or IPA.
Conditions covered by workers compensation or similar law.
Experimental or investigative services.
Services provided by a local, state, federal or foreign government, unless you have to pay for them. Blue Cross HMO Brochure |
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| So, if you're self employed or a Corporate Officer and are NOT required to have Workers Compensation, nor can you probably get it. You would be COVERED by virtually ALL Individual Medical Plans. |
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| Group Medical Plans will typically make you sign off that you are excluded under the Worker's Compensation Laws. |
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Principal Exclusions and Limitations on Benefits
General Exclusions
Blue Shield does not provide benefits for services or procedures that are:
22. for or incident to any injury or disease arising out of, or in the course of, any employment for salary, wage, or profit if such injury or disease is covered by any workers? compensation law, occupational disease law, or similar legislation.
However, if Blue Shield provides payment for such services, it will be entitled to establish a lien upon
such other benefits up to the reasonable cash value of benefits provided by Blue Shield for the treatment of the injury or disease as reflected by the providers usual billed charges; Page 15 www.blueshieldca.com
Definition of Employee
Self Employed Deduction for Medical Insurance |
        
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