What type of treatment is not covered under the HealthAccess MedGuard plan if it is covered by the North Carolina Workers' Compensation Act?

The correct answer is that medically necessary treatment of a bodily injury is not covered under the HealthAccess MedGuard plan if it falls under the provisions of the North Carolina Workers' Compensation Act. This is because the Workers' Compensation Act is a specialized insurance system designed to cover job-related injuries and illnesses. When an injury or illness is deemed to be work-related and thus compensable under this act, it typically means that the responsibility for covering the costs falls to the workers' compensation system instead of personal health insurance plans like HealthAccess MedGuard.

In this context, the plan would not overlap with the coverage provided by Workers' Compensation, which covers necessary medical treatments directly related to job injuries for those eligible. This delineation helps prevent duplication of benefits and clarifies which insurance entity is liable for claims related to work-related injuries, ensuring that individuals receive appropriate compensation through the correct channels.

Cosmetic surgery, preventative care, and routine check-ups do not fall under the typical coverage of the Workers' Compensation Act as they are generally not work-related. Therefore, they can still be covered by the HealthAccess MedGuard plan, making them distinct from medically necessary treatment related to bodily injuries sustained while working.