Personal Injury Settlement Affect Medicare
Receiving a personal injury settlement will not stop you from receiving Medicare. However, Medicare is entitled to a portion of your settlement for any medical care you received. You must report your settlement to Medicare within a certain period or risk a fine.
The Law Offices of Wolf & Pravato advocates for injured claimants in South Florida. If you’re concerned about how your settlement will affect your Medicare coverage, call us at (954) 633-8270.
A Personal Injury Settlement Affects Medicare
Medicare offers healthcare coverage to disabled individuals and seniors over 65 years old. If you suffer harm due to negligence, Medicare may pay for your treatment. However, it expects reimbursement through your personal injury settlement. Unlike many insurance companies, it does not negotiate for lower payments. It expects the full sum of what it paid for your treatment.
Consider this scenario to understand more:
- You suffered harm in a car accident.
- Your medical expenses total $100,000.
- Medicare pays for your injury-related treatment.
- You resolve your case via an injury lawsuit and get $100,000.
- Medicare is entitled to those funds, since it paid for your medical care while your case unfolded.
Imagine that while undergoing treatment for your collision-related injuries, you get pneumonia. Medicare would pay for the treatment you needed for pneumonia. You would not have to pay back those funds through your injury settlement only for the harm you suffered in the collision.
You Must Notify Medicare of Your Injury Settlement
Once you’re awarded compensation, you have 60 days to report the settlement to Medicare. This is absolutely mandatory. Medicare could fine you for each day that you don’t report the settlement and those fines can cost thousands of dollars.
You can report your settlement through the Centers for Medicare & Medicaid Services (CMS). You must provide your:
- Medicare number
- Address and phone number
- Accident’s date
- Injuries’ description
You must also describe the type of claim you filed and give the liable insurer’s information. If you’re working with an attorney, you can give their name, phone number, and address to CMS.
Medicare Will Send You a Letter
After reporting the settlement, within 120 days, Medicare will send you a notice. It will list all of the expenses it believes you should pay. You have the right to look over the notice and appeal any charges unrelated to your condition. From there, once you have a firm list of itemized expenses, you’ll get a final payment demand within 30 days.
At this point, you have two options:
- You can pay Medicare with your settlement.
- You can appeal the notice with your attorney’s help.
You must pay Medicare the money it’s owed. Failure to do so is a criminal offense. It could also make you ineligible for Medicare benefits in the future.
Don’t Assume Medicare Won’t Find Out About Your Condition
After receiving compensation, many Medicare claimants ask, “How’s Medicare going to find out about my settlement? Do I really have to report it?” Medicare flags certain treatments when evaluating your records. Consider another scenario to understand more:
- You suffered a broken leg in a collision.
- Medicare pays for your treatment.
- When evaluating its records, it will ask if you suffered harm due to negligence.
- You must answer faithfully.
If you broke a leg after slipping in your driveway, Medicare would pay for those treatment-related expenses if you did not file a third-party claim. Matters change if you suffered harm because of another party’s actions.
In that case, the liable insurer should pay for your expenses not Medicare. However, Medicare may finance your treatment while your case unfolds. It will expect reimbursement at your injury claim’s conclusion.
Consider Your Legal Options After Suffering Harm
Understanding how your settlement affects Medicare can get confusing especially if you had a pre-existing condition before your accident. This is where partnering with a Fort Myers personal injury attorney could benefit you. They can:
Explain Any Exceptions
Medicare treats each case differently. For instance, if your medical expenses totaled less than $5,000, it may only take a certain percentage of that sum. If you partner with a lawyer, Medicare may reduce what it’s owed by one-third.
Understanding any case-related exceptions ensures things move smoothly. As mentioned, any misstep could result in fines or the termination of your benefits.
Calculate Your Direct Medical Expenses
Medicare is not entitled to compensation for your lost income, pain and suffering, and other related damages. It only gets compensation for the necessary medical treatment you required.
Your attorney will evaluate your condition by consulting with your healthcare team. This will help them understand the cost of your past, present, and future medical treatment. Then, they can determine what you owe Medicare.
Help Report the Accident to Medicare
You may have anxiety about reporting your accident-related injuries to Medicare. Your Fort Lauderdale personal injury lawyer can help you notify the organization and fill out all appropriate paperwork.
Call us for a Free Case Review with the Law Offices of Wolf & Pravato
Your personal injury settlement will not stop you from receiving Medicare. However, you must notify the organization of your settlement and pay back certain funds. To learn more, call the Law Offices of Wolf & Pravato at (954) 633-8270. We can support you during this challenging time.