A concern of many clients who are involved in a personal injury lawsuit is how they are going to afford the large amount of medical bills that they will have to pay. Bills and expenses for serious injuries may seem like more than an individual could ever afford on their own. The goal of a lawsuit is to recover enough money from a potential wrongdoer to ensure that all of the medical expenses are paid for—or at least a significant portion of those expenses.
Prior to a settlement or a judgement, however, an injured person must pay for their medical costs out of pocket or through another source like private insurance or Medicare. Both Medicare and private insurers can be difficult to negotiate with, but Medicare can present especially difficult challenges.
How does Medicare affect my personal injury settlement or judgment?
Medicare is a federal program that provides health insurance to individuals who are over 65 and have met certain employment history requirements. It also affords benefits to certain individuals with disabilities who are under 65 as well as people with specific diseases. Medicare is broken into four parts: A (hospital insurance), B (medical insurance), C (Medicare advantage plans) and D (prescription drug coverage).
By law, Medicare is known as a secondary payer for injuries and treatment. This means that if you are injured you need to go through all coverage from other sources (like private insurance or workers’ compensation) before Medicare will cover any of your expenses. When Medicare pays for medical expenses, they get can get a lien on your recovery. This means that they are entitled to be paid back out of your settlement or a judgement that awards you compensation.
When do I have to involve Medicare in my personal injury lawsuit?
Experienced lawyers will recognize early in your case if Medicare will be an issue. When you receive a judgement or settlement, Medicare must be promptly notified of the amount so the process determining whether or not there is a lien can be started. If there is a lien (Medicare has paid for some of your medical expenses) then Medicare’s Benefits Coordination & Recovery Center will issue you or your attorney a letter demanding reimbursement out of your total recovery. This letter will include a summary of all the payments made by Medicare and the total amount that is being demanded. The letter will usually also include information about your rights to appeal Medicare’s demand.
Have you been injured, and are you eligible for Medicare?
Above is only a brief summary of some of the issues related to Medicare that arise during a personal injury lawsuit. Dealing with liens, insurance and Medicare can be a complicated end to your personal injury case. At Surasky Law, we are committed to helping you with the entire process, from your initial filing to obtaining your final check. We understand that Medicare cases can be complex and difficult for the average person to navigate. We are here to help you with your personal injury claim. Contact us today for a free consultation.