Over 140 million individuals in the United States receive health insurance benefits through Medicare or Medicaid. If you receive this type of coverage, it may be used to cover your hospitals bills after an auto accident. However, there is a catch.
Many clients have the misconception that their entire settlement check, after attorney’s fees and case costs are deducted, belongs to them. But, to many people’s surprise, Medicare or Medicaid must be reimbursed for medical expenses paid on your behalf following your car wreck or other at-fault injury.
If Medicare or Medicaid assisted in paying for your medical treatment, they have a right to be reimbursed out of your settlement. This is because Medicare or Medicaid has a lien against your personal injury settlement. Any knowledgeable and direct attorney handling your case will tell you this information as soon as it is made clear that your treatments are being paid by Medicare or Medicaid.
Once you go to the hospital for any medical treatment stemming from your car accident, the hospital will file a claim with Medicare or Medicaid for reimbursement. However, it is important to remember that just because Medicare or Medicaid paid for your treatment does not mean you are off the hook!
If Medicare or Medicaid assisted in paying your medical bills, you must report the accident to them. If you do not report the auto accident, once they receive medical bills from your physician, they will contact you. There is no way to get around this. Once your lawyer finalizes a settlement with the at fault driver’s insurance company, he or she should notify Medicare or Medicaid of the settlement.
When Medicare covers medical bills for you, the payment is conditional. This means that the Medicare recipient has an obligation to repay Medicare for their conditional payments. If the at fault driver’s insurance company receives the conditional payment letter (CPL) from Medicare, the insurance company will typically pay out Medicare before disbursing the remainder to you and your attorney. You may also receive a check payable to Medicare and another check payable to you or your attorney for the remainder of the settlement. However, if the insurance company was not given this CPL, it is up to you to reimburse Medicare from your proceeds from the case.
There is typically no negotiation regarding the amount you must repay to Medicare. So, you must reimburse Medicare for all medical bills that were paid on your behalf.
If Medicare is not paid out of the settlement, then they will send out a demand letter to you requesting payment. You will have 60 days from receipt of this demand letter to make the payment before interest begins to accrue.
The same rules apply to Medicaid. If your treatment was paid for through Medicaid benefits, you are obligated to reimburse them for the exact amount they paid to your health care providers. This amount may be obtained by contacting Medicaid to find out the exact amount owed. Again, this amount will come out of your settlement proceeds.
Because you may unknowingly owe money out of your settlement, it is important to hire an experienced attorney to protect you from a surprise government lien after your case settles and all the money is disbursed!
If you or a loved one were involved in a car accident, let us help you navigate through these tricky issues regarding Medicare or Medicaid reimbursements. PHONE CARDONE at 504-522-3333 for a free consultation today.