What Does Medicare Cover?
Are you suffering from auto accident injuries and wondering if Medicare will cover them? Getting to know Medicare requires a detective cap. If you’re 65+ or have an elderly parent who’s been injured, you might need help. Besides hiring an experienced personal injury attorney, you should educate yourself.
During a medical injury, Medicare may cover costs. Medicare must be reimbursed if any costs it pays are due to injury and there is a successful personal injury case outcome with settlement funds.
In order to ensure reimbursement, Medicare attaches a lien to any compensation received. Medicare does not allow for much negotiation when it comes to lien amounts, unlike private health insurance.
MEDICARE PROCEDURES AND RULES THAT YOU SHOULD KNOW
- Federal law requires that you notify the Medicare Coordination of Benefits (COB) contractor after an accident requiring medical treatment. You can find the contact information on one of Medicare’s websites, cms.gov or medicare.gov.
- A COB notification must be sent once your case has settled. This must be done before settlement proceeds are distributed.
- All medical bills that Medicare paid on your behalf must be reimbursed. The amount to be repaid by Medicare is calculated very strictly.
- You’ll get a check after your lawyer reviews and agrees on the conditional amount paid, based on Medicare’s formula. You and your attorney can appeal the statement internally if you think it is inaccurate.
The penalties for not paying back the Medicare lien are significant. There are penalties for both the Medicare beneficiary as well as the attorney for failure to properly address a Medicare lien. That is why one of the first questions most personal injury attorneys will ask is whether or not you received any medical treatment through Medicare.
“One of the benefits of hiring an attorney is that the client can concentrate on getting well. Aspects of a personal injury claim are time-consuming and complicated,” Brad Parker says. “We can deal with insurance companies, bill collectors and outstanding liens, which reduces stress on the client.”