Will Medicare get part of my injury settlement?
Will Medicare get part of my injury settlement? Yes, if part of your medical bills has been paid by Medicare. The law provides they are entitled to be reimbursed. Often Medicare will deny the payment of medical bills that arise out of an injury accident or an on the job injury. However you can get them to pay conditionally. If there is a delay getting the liability insurance company to pay Medicare may pay. If the liability insurance company is disputing your claim then Medicare might pay your medical bills. This is called a conditional payment. This means they pay the bills but if you get a recovery for the medical bills you will need to repay Medicare. This works to your advantage. Medicare pays the medical bills but not at full rate. You only have to pay Medicare the amount Medicare paid your medical providers.
When Medicare is notified of your accident, they send a conditional letter, and then after you have settled the case, they will send you the demand amount. Steps can be taken to
make sure the amount is correct. Don’t assume that the amount sent in the first letter is the right amount of their claim. Often, they will simply list all treatment paid for after the accident, and you must contest the amount. To avoid this problem, we include the treatment and diagnostic codes in the first notice to Medicare. Medicare will also lower the demand to recognize the attorney’s expenses and fees.
What’s the first step?
Contacting the BCRC is always the first step for interacting with Medicare if you have
a pending NGHP claim. The BCRC needs the information below to get started:
- Beneficiary Information
– Beneficiary’s Name
– Beneficiary’s Health Insurance Claim Number (HICN)
– Beneficiary’s Gender & Date of Birth
– Beneficiary’s Address & Phone number
- Case Information
– Date of Incident (DOI): Date of injury/accident, date of first exposure or ingestion,
date of implant.
– Description of alleged injury or illness; description of alleged harm.
– Type of Claim (liability insurance [including self-insurance], no-fault insurance, workers’
compensation).
– Insurer/workers’ compensation name & address.
- Representative Information
– Representative/attorney name
– Law Firm name if the representative is an attorney
– Address & phone number
So will Medicare get part of my injury settlement? Yes but make sure they don’t get more than they should, give us a call. 785-273-4330.