When you look for medical care after an accident that was caused by somebody else, it can be difficult to figure out who should pay for it. Should the at-fault party pay? Should you? Should your health insurance? Sometimes the answer is one, and sometimes all of them play a roll. But when Medicare is in the mix, things get complicated. People covered by Medicare have special obligations in cases where they are making personal injury claims, and if those obligations are not carefully considered and addressed, it could lead to losing your Medicare benefits.
Medicare is a secondary payer. That means, Medicare will only pay for medical treatment if there is no other medical plan to pay for it. if you break your arm at work, workers compensation pays for your care. Medicare would not pay for a workplace injury until a workers compensation coverage ended. If you had an employer health plan plus Medicare, you must use your employer health plan before your Medicare plan. Medicare is alwasy at the “back of the line” when it comes to responsibility to pay for your medical care.
Once medical treatment after an accident is complete and you settle your claim against the at-fault party, Medicare requires you to repay it from your settlement. Medicare’s argument is that it was the at-fault party that should have paid for your treament in the first place. Their payments were conditioned on being repaid once you settled your case.
If you have questions about dealing with Medicare after an accident, give us a call.
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