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Counsel That You Can Trust & Depend On


Guy DiMartino Oct. 31, 2014

Northwest Indiana personal injury lawyer explains whether Medicare will pay for your accident related injuries.

If you have been injured in a Northwest Indiana car, truck or motorcycle accident and are a Medicare recipient, will Medicare pay for your medical treatment? The answer is yes, if there is no other insurance medical insurance available.

In the context of a Northwest Indiana automobile accident, primary insurance would consist of medical payments coverage under your automobile insurance policy or a group health plan. If you do not have medical payments coverage or the limit of your medical payments coverage has already been paid out, your doctors can bill Medicare for your medical treatment. The payments made by Medicare are considered “conditional”. Medicare makes these payments with the understanding that if you receive compensation from the other side for your injuries, Medicare will be repaid for the monies it paid to your doctors. The following process is followed when dealing with Medicare payments:

  • Medicare is put on notice of the claim

  • Your attorney will provide notice of representation

  • Medicare will send out a questionnaire within 45 to 60 days

  • Medicare will make “conditional payments” to your healthcare providers

  • Medicare will send out periodic payment history – many times the payment history contains medical services that are not related to the injuries sustained in the accident

  • When you are done treating – Medicare will be put on notice

  • Medicare will utilize a formula to determine the amount of repayment required. The formula takes into consideration the costs associated with reaching a settlement and the attorneys fees. Medicare will make an adjustment for these attorneys fees and costs.

  • Once Medicare has established the amount of reimbursement it will submit serve you and your attorney with a demand for repayment.

The Medicare procedure has a tendency to be complex and tedious. When Medicare payments are involved in a car, motorcycle or truck accident case disbursement of settlement proceeds will take more time because Medicare takes a while to provide its right of reimbursement. Indiana accident law is complex and when Medicare is involved it becomes more complex. If you have any questions regarding your Indiana accident case and Medicare issues, call our office at (219) 874-4878.