Cap Article from Army Times Website

[RiverAux]

Folks, if you are over 18, you are covered for any injuries incurred on an AFAM.  I don't know why DNALL keeps saying you aren't.

CAPR 900-5

SECTION D—AIR FORCE-ASSIGNED MISSIONS—FECA (FEDERAL EMPLOYEES COMPENSATION ACT) COVERAGE FOR CAP MEMBERS
13. FECA Coverage For CAP Members. FECA is the Workmen's Compensation Program for federal workers. By special law (5 USC 8141), FECA is made applicable to CAP seniors and cadets 18 and older while serving on Air Force-assigned missions, including travel to and from.
14. FECA Benefits. FECA benefits for paid federal employees are computed on a percentage of actual salary. There is a special provision in the FECA law that makes CAP volunteers "federal employees" and "presumes" that the CAP member is paid at a GS 9, Step 1 level. Percentages of that salary are taken to compute CAP FECA benefits. A GS-9, Step 1 annual salary as of January 1, 2003 is $35,519. Actual FECA benefits are determined by the Department of Labor (DoL) claims examiners in accordance with DoL guidelines. Approximate benefits for CAP members are as follows:
a. Medical Benefits. Full medical benefits for member's covered injury/condition are allowed, as are rehabilitation services and attendant allowance consistent with applicable DoL guidelines.

Workman's comp pays all the costs assuming your claim is approved. 

17. Filing FECA Claims. FECA is administered by the DoL who retains final decision authority on FECA claims. FECA claims are processed through CAP-USAF/JA. Members will forward all FECA claims and DoL forms relating to FECA claims to CAP-USAF/JA for review and submission to DoL. HQ CAP/GC assists CAP-USAF/JA to ensure all claims and supporting documentation are accurate, timely, and filed in accordance with DoL rules and procedures. CAP members and CAP-USAF employees may be asked to assist with the claims effort, as circumstances warrant.

There are much more limited medical benefits for injuries received on corporate missions/activities. 

18. General. As a benefit of membership, CAP provides a self-insured accident coverage for both senior members and cadets, which provides benefits in the event of reportable injury or death that occur during CAP authorized activities. This is a self-insured program paid out of CAP's general fund and not a commercial insurance policy.
19. Senior and Cadet Benefits:
a. Accidental Death - $10,000
b. Medical Expenses - $8,000 less a $50 deductible per claim
20. Medical Expense Benefit Excess to Existing Coverage. The CAP medical expense benefit is excess to any existing medical coverage available to senior or cadet members including family or employer type "Blue Cross" or HMO coverages. These other coverages must be exhausted before CAP provided self-insured medical expense benefits apply. The CAP medical expense benefits will pay (a) if there is no other applicable insurance, or (b) for that portion of the other policy coverage not paid such as coinsurance deductible (not including standard deductibles), etc., up to $8,000 per occurrence. All medical expense benefit payments are subject to the $50 per claim deductible.

[isuhawkeye]

The CAP medical expense benefit is excess to any existing medical coverage available to senior or cadet members including family or employer type "Blue Cross" or HMO coverages. These other coverages must be exhausted before CAP provided self-insured medical expense benefits apply. The CAP medical expense benefits will pay (a) if there is no other applicable insurance, or (b) for that portion of the other policy coverage not paid such as coinsurance deductible (not including standard deductibles), etc., up to $8,000 per occurrence. All medical expense benefit payments are subject to the $50 per claim deductible./quote]

Great coverage.

I dont know about you, but my last admission to the hospital cost significantly more than 8,000 and that was without surgery. 

[RiverAux]

Keep in mind that that is only for stuff that happens on corporate missions or at meetings or other activities.   

[SAR-EMT1]

So what about the AFAMs ?

[RiverAux]

Fully covered under federal workman's comp for injuries as the regulation says. 

[Johnny Yuma]

Fully covered under federal workman's comp for injuries as the regulation says. 

Yes, for medical and/or if you die or can never work again.

Temporary disability - Up the Feces River

[Johnny Yuma]

I spent 2 days in a hospital in 2004. That, 6 meals, 6 shots of Cumadin, telemetry strapped to me and a treadmill test was $7,000 not including the P.A. costs for the attending physician which was another $700 for visiting me 3 times including the ER examination.

The CAP medical expense benefit is excess to any existing medical coverage available to senior or cadet members including family or employer type "Blue Cross" or HMO coverages. These other coverages must be exhausted before CAP provided self-insured medical expense benefits apply. The CAP medical expense benefits will pay (a) if there is no other applicable insurance, or (b) for that portion of the other policy coverage not paid such as coinsurance deductible (not including standard deductibles), etc., up to $8,000 per occurrence. All medical expense benefit payments are subject to the $50 per claim deductible./quote]

Great coverage.

I dont know about you, but my last admission to the hospital cost significantly more than 8,000 and that was without surgery. 

[DNall]

You understand there are different kinds of insurance. For instance, your car insurance probably provides coverage for health expenses for you/passengers/other party, but it is NOT health insurance, it is auto liability insurance. You cannot show up at the hospital waiving your auto insurance card & expect treatment. It is no guarantee of payment, and there are no negotiated payment rates in place btwn the insurer & the health care provider.

The matrix of coverage btwn CAP & govt, AFAM & corp activities, is liability & workers comp insurance. All facilities will provide life saving emergency care. Aside from that, you need your own coverage or ability to pay in order to initiate & sustain treatment. Well after the fact, the govt/CAP will consider the claim for reimbursement based on the terms of the coverage.

A significant number of claims are turned down for technicalities ranging from paperwork to policy violations. I'd cite as an example a recent crash on AFAM where coverage was denied because the flight release paperwork was done incorrectly. I don't know if it was this case or not, I just know I got something official on it.

What I'm saying is you need your own coverage, first of all to make sure you actually get treated, and second of all to make sure it gets mostly paid for. You can't count on the govt/CAP cause you don't know for sure they'll be there for you when it matters. The way I look at it, CAP ES service can be more dangerous than my regular civilian life. The additional coverage from the govt for those instances allows me to not need additional private insurance to cover that additional risk. I still need my own insurance, I just don't need any extra coverage because I happen to be in CAP.