Faqs About Paying Medicare After An Accident

After negotiating with the insurance company to receive compensation from an accident, you must reimburse Medicare for any accident-related expenses it covered. If you fail to do so, there could be serious consequences. If you are a Medicare recipient and are expecting a settlement from an accident, here is what you need to know. 

How Does Medicare Know About the Settlement?

You are legally required to notify Medicare when you are involved in an accident that requires medical treatment. The accident has to be reported to the Medicare Coordination of Benefits Contractor, or COB. 

If you fail to report the accident to the COB, it is likely that Medicare will find out anyway. Medicare automatically flags payments that could be linked to an accident during processing. At that point, you and your medical care provider could be contacted for additional information. You have a legal responsibility to respond to the request for details about your accident. 

What Happens When Your Case Is Settled?

Medicare will check in with you periodically to determine the status of your case. If you have a personal injury attorney at this point, the agency will also contact him or her. 

After the case is settled, Medicare will send a bill listing all of the services that it paid for. You are expected to pay by the date listed on the notice.

You and your attorney can review the bill listing and determine whether or not all bills listed are accurate. If not, your attorney can send a letter to Medicare detailing why it should not be included. If Medicare agrees, the bill can be removed from the ones that you owe. At that point, you are required to reimburse Medicare for the validated debts. Your attorney will send the check from the settlement on your behalf. If you fail to pay, you could lose your Medicare eligibility. 

What If Medicare Says You Owe a Debt You Do Not?

In the event that Medicare believes that you owe reimbursement for a bill that you do not and still refuses to remove it after your attorney's letter, you can file an appeal. It is important to note that you cannot receive the amount of the settlement that is in dispute until the appeals process is completed. 

Your attorney can help you handle the payments to Medicare for accident-related expenses. If you do not have an attorney yet, consult with one to avoid losing your coverage due to a dispute with Medicare. Contact a firm, such as the Erickson Law Office for more information.