Your responsibility to Medicare if you are involved in an accident
Winter driving conditions here in Idaho can be difficult at times and can lead to accidents. In a situation where a person on Medicare sustains injuries that are caused by someone else, Medicare becomes a secondary payer and the no-fault or liability insurance becomes the primary payer. When an individual who is covered by Medicare is injured in an accident, Medicare requires that person to notify Medicare of the accident.
While the process of obtaining treatment for injuries is the same, payment of the medical bills is very different. Medicare makes conditional payments to healthcare providers for their services, but Medicare is entitled to repayment from the third party responsible for the accident. This is the case whether the injury happens at work or in an automobile accident. If a person on Medicare recovers an insurance settlement for his injuries, Medicare will automatically have a lien against the settlement for any medical bills it has paid on behalf of the insured. Therefore, if a Medicare beneficiary receives a settlement from a primary payer, that person will need to reimburse Medicare for the amount of medical bills that Medicare paid.
For example, we know of one man who had an accident and settled with the liability insurance company for $1,500 and then had back surgery paid for by Medicare. When Medicare became aware that he had been in an accident, they sent the man a letter demanding reimbursement for the total cost of the surgery.
Consequently, if you are on Medicare and you are injured in an accident, make sure you or your attorney contacts Medicare before making any kind of settlement with an insurance company.
Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a Senior’s legal, financial or healthcare needs, please call us.