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Case Management Focus
Sarasota, Fl (WorkersCompensation.com) -- In this post, I will share why I think Workers' Compensation Insurance is the Premier Insurance for people.
When I started working in workers' Compensation a fellow nurse case manager said, 'You either love workers' Compensation or you hate it. There is no in-between. ' As a nurse case manager who has worked in catastrophic case management, both in workers' Compensation and Group Health, I must agree.
For the injured worker, workers' compensation benefits are excellent—no co-pays, no deductibles, and mostly everything a doctor recommends is paid for by the insurance company if it is related to the work injury. One doctor said at a conference that workers' Compensation is the 'premier insurance' because it provides a more inclusive policy with little cost to the person compared to medical insurance.
On the other hand, employers offer commercial healthcare insurance, or an individual can pay for a policy called Individual Health Insurance. Both have associated costs such as deductibles, co-pays, and out-of-pocket costs. Individual Health Insurance is complex to understand, especially if you are sick, you can’t work resulting in the loss of your employers insurance.
If an employer provides health insurance for their employees, they usually works with a broker who shop for the lowest costs policy. These policies usually have restrictions that limit care options and have high deductibles. Those who choose individual policies can select from an array of policies. A separate policy is more expensive and comes with costs that raise the price for the individual. It is a no-win situation.
A workers' compensation policy is paid for by the employer at no cost to the employee, while a group health policy is subsidized by the employer. An employee pays their portion of the policy but really has no say in the type of policy they get.
So yes, WC insurance is the premier insurance for a people. The best benefit of a workers' compensation policy is that a nurse case manager can assist with care coordination, transition of care, and breaking down barriers that impede the patient's care. On the other hand, commercial policies make it hard to find a case manager as they tend to be hidden from policyholders.
As I have often said, if you have to get injured or become ill, do it at work so you are covered under your worker’s comp policy.
I write this post to help readers to become aware of the importance of advocating for affordable healthcare. The Affordable Healthcare Act passed in 2010 was a start, but we have a long way to go till commercial healthcare policies measure up to a worker's compensation health insurance policy. Case Managers who do both know this and should be advocating on the State and Federal Levels to find ways to ensure everyone is covered under a comprehensive healthcare policy…..that will help them with reasonable care and reduce sick care and the associated costs!
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About The Author
About The Author
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Anne Llewellyn
Anne Llewellyn is a registered nurse with over forty years of experience in critical care, risk management, case management, patient advocacy, healthcare publications and training and development. Anne has been a leader in the area of Patient Advocacy since 2010. She was a Founding member of the Patient Advocate Certification Board and is currently serving on the National Association of Health Care Advocacy. Anne writes a weekly Blog, Nurse Advocate to share stories and events that will educate and empower people be better prepared when they enter the healthcare system.
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