I am on Medicare. If I am hurt in an accident, does Medicare affect my personal injury case?

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The fact that you are on Medicare may affect what happens to your settlement after the completion of the case but shouldn’t affect the actual case itself. If you are on Medicare and you are injured, Medicare may cover the cost of your medical care. However, if you receive any settlement or judgment as a result of a personal injury claim, you must repay Medicare for any payments Medicare made because of the injury.

Also, legally Medicare has an automatic lien on any compensation you receive from your personal injury claim. Therefore, Medicare has a claim to the judgment or settlement funds and the Medicare lien is superior to any other person or entity. Medicare normally does not negotiate down its lien amount.

Medicare requires its recipients to report, within 60 days, any settlement or judgment resulting from any personal injury claims for which it has paid medical claims. If a recipient fails to timely report, he or she can face significant fines of up to $1,000 per day. Medicare allows reporting of personal injury claims electronically from its website. After a report is made, Medicare will send out the amount of the lien and a notice of all the charges for which it believes it should be reimbursed. You will review that list of charges with your attorney to ensure that they are only for medical treatment that is related to your personal injury claim.

After you have approved the final list of charges, Medicare will send a final payment demand, and you or your attorney must either pay it or appeal. Although it may be tempting to fail to report the settlement or judgment, it’s likely that Medicare will find out that you have done that. Medicare flags some payments it makes for certain medical treatments associated with personal injury claims. If you refuse to report a settlement or lie to Medicare after receiving correspondence from Medicare, you may lose your eligibility for Medicare and you may have committed a criminal offense.

If you have any questions about personal injury cases in the Houston area, call the Houston personal injury attorneys at Kennedy Hodges at 855-947-0707. We can help. Call us today to learn more or to schedule a free consultation or visit us on Facebook.

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