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Medicare & Personal Injury Claims

If you have been injured and have filed a personal injury claim while also receiving Medicare, you are required by law to repay Medicare for payments made for treatment of the injury out of your personal injury settlement.

Repaying Medicare from Personal Injury Claims

Medicare places a lien on compensation from personal injury settlements. A lien is a legal claim on a property in order to settle a debt. If Medicare is not paid back for money paid out as a result of injury, it has the legal right to secure the entire settlement.

Within 60 days, the amount of the settlement must be reported. If it goes unreported, a fine of up to $1000 per day can be applied. Once reported, Medicare will release the amount of the lien. The lien can only be applied to Medicare expenses related to the personal injury claim, so ensuring that all charges on the lien are accurate is important.

Federal law requires that Medicare is reimbursed for all paid out amounts, so there are very little options to negotiate a smaller payout.

Important Notes for Medicare Reimbursements

For settlement claims where the total payout is less than $5,000, there is a fixed percentage option available for repayments. Medicare will take 25% of the total settlement as a full repayment instead in this scenario.

Even if an Admission of Liability is signed by the claimant, Medicare must be reimbursed. An Admission of Liability is a document releasing the insurance company, on behalf of the insured, of any fault in relation to the accident.

Failure to report a settlement to Medicare could result in criminal offenses and jeopardize future eligibility. Medicare flags payments that seem to be related to personal injury treatments for follow-up, so before you even seek a settlement, Medicare may be aware a potential claim.

To avoid the negative effects that come from not alerting Medicare of a settlement for your personal injury lawsuit, it is helpful to report the results as soon as possible. The personal injury lawyers at Whitley Law Firm can help ensure that your settlement is not over until your Medicare claim has been squared away. Call our firm today!