Medicare Reimbursement and Personal Injury
If you qualify for Medicare, because of age or disability, you will likely be fortunate enough to receive coverage in the event of an accident or actions of another that result in your injury. Should you go on to file a lawsuit to recover for the injuries from the party responsible for causing them, you should be aware that as per federal law, if you receive compensation, Medicare must be paid back for all medical bills paid on your behalf.
Medicare is a federal insurance program, and therefore, federal law and rules primarily govern how the program is administered. Under federal rules, Medicare is not supposed to cover a recipient’s medical expenses if they are covered or expected to be covered under an automobile or other liability insurance, including a self-insured policy. Doctors and other medical professionals treating a Medicare recipient are supposed to first bill the other insurance, and usually if there is a delay of more than 120 days, they may bill Medicare. Generally, if there is a delay in the insurance policy making the payout due to a disagreement as to whose insurance is supposed to cover injuries after an accident, Medicare may cover the recipient’s medical bills contingent on reimbursement.
Procedure After Injury
When a recipient gets into an accident, they are required to report when they make a claim related to the accident to the Medicare program immediately, which then tracks the case to ensure that the recipient reimburses the program for all expenses paid that relate to the accident. After the injured person receives compensation for the injuries, the Medicare Benefits Coordination & Recovery Center sends the recipient and his attorney or representative a demand letter seeking reimbursement.
An attorney receiving a settlement on behalf of a client may release the funds to the client less any reimbursement funds due to the Medicare program, and forward the rest of the funds to the program on the client’s behalf. If the client or recipient disputes any of the charges that Medicare claims to have paid, because they are not related to the accident for example, then the attorney may hold on to those funds in a trust account until the dispute is resolved. The recipient and the attorney should ensure they check all claims sent from Medicare for reimbursement to make sure that the proper medical bills are being passed on for reimbursement.
Additional Considerations For Certain Injuries
For injuries related to the continued exposure to environmental hazards, or ingestion of a dangerous substance, there are different dates that matter in terms of Medicare reimbursement after cases settle. The dates of first and last exposure are important and could mean different things for your case. It is important to discuss what dates must be reported to Medicare with your attorney before submitting paperwork to ensure you are within the guidelines.
Contact A Fort Lauderdale Personal Injury Attorney
If you were injured due to the negligence of another person in an automobile or otherwise, you need a personal injury attorney fighting for you while you concentrate on your recovery. Contact the experienced Fort Lauderdale personal injury attorneys from Boone & Davis for a consultation today.