Your primary health insurance coverage takes care of many things, but an on-the-job injury might not be one of them. Nevertheless, you might be led by misinformation or even your own employer to use your own health insurance instead of filing a claim for workers' compensation benefits. Attempting to use your own health insurance coverage can come with plenty of unexpected drawbacks, as shown below.
Your Doctor May Refuse to Provide Treatment
What happens when your doctor finds out you're using private health insurance to cover a work injury normally covered by worker's comp? Your doctor might be less willing or even refuse outright to provide treatment. As horrible as this might sound to you, there's a very good reason why your doctor would be reluctant to continue treatment under these circumstances.
As a rule, private health insurance providers won't pay for treatments related to work-related injuries. Since these injuries are typically covered by your workers' compensation benefits, using your own health insurance coverage constitutes "double-dipping"—a practice that providers strive to avoid at all costs.
Once your health insurance provider finds out you're using your coverage for a work-related injury, any and all existing payments for medical treatment many come to a swift end. The same goes for any authorization of future payments. Your health insurance provider may even ask you to reimburse any funds used towards your treatment.
Your Health Insurance Won't Pay Disability Benefits
Workers' compensation takes care of more than just your medical bills. Being out of work for an extended period can easily result in significant lost wages. Unless you have a sizable nest egg or a massive rainy day fund to tap into, it's easy to be consumed with worry over how to handle ordinary bills and day-to-day expenses.
Filing a workers' comp claim entitles you to receive disability benefits if your injuries prevent you from returning to work. It's a benefit you won't get if you go through your private health insurance provider, instead.
Your Health Insurance May Not Cover All Expenses
Primary health insurance plans often have coverage caps that vary depending on the type of plan. A serious workplace injury can easily exceed most coverage caps, leaving you personally responsible for any medical expenses that exceed your cap. Most health insurance plans also require a deductible and/or a co-pay before you can fully take advantage of their benefits.
In contrast, workers' compensation is designed to cover all of your medical expenses related to your workplace injury. That means you won't have to worry about covering any out-of-pocket costs. Using workers' comp instead of your private health coverage can significantly reduce potential expenses.
Your Traveling Expenses for Care Won't Be Covered
Certain injuries may require the care and expertise of a skilled specialist for the best possible medical outcome. Living in a rural or remote area can make these visits an unexpected hardship, especially if you need to travel to the nearest major city to see your specialist. Most private health insurance plans won't compensate you for traveling these long distances.
Workers' compensation, on the other hand, can ease the burden of visiting your specialist by reimbursing your travel costs. While some states set their own mileage rates, most states stick with the IRS-formulated mileage rate of 54.5 cents per mile. In addition to fuel, you may also receive compensation for parking, tolls and even public transportation fare.
Filing for workers' compensation ensures that you receive the benefits you deserve whenever you're injured on the job. Using your private health insurance coverage could prove costly and create unnecessary delays in treatment and healing. To learn more about filing for workers' compensation, contact a law office like the Law Office of Joel A. Santos.Share