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PERSONAL INJURY AND MEDICARE: WHAT YOU NEED TO KNOW

If you sustain a personal injury as a result of someone else's negligent, reckless, or intentionally dangerous actions, you may be entitled to receive a settlement. In most cases, settlements such as these are paid out by insurance companies, but if you are a Medicare recipient, you may have to forfeit some or all of the settlement you are entitled to.

Generally, when a person covered by Medicare is treated for an injury, those costs are covered by Medicare. Those costs are then reimbursed through a settlement or by insurance companies. Medicare is entitled to be reimbursed for all costs it has satisfied, and it is the Medicare recipient who is responsible for that reimbursement; pursuant to the Medicare Secondary Payer laws, Medicare does not have to cover medical expenses if a settlement or other award has been granted from an insurance company to the enrollee.

Things to Keep in Mind

If you are working through a personal injury case and are enrolled in Medicare, there are a few tips and bits of advice to keep in mind throughout the process:

  • Document, document, document: As with any type of lawsuit or insurance claims, it is vital to maintain thorough documentation.
  • Have access to your Medicare card and maintain all correspondence to and from Medicare
  • Move quickly: Generally, it can take a long time to get a response from Medicare's Benefits Coordination and Recovery Contractor. The sooner you notify them, the better.
  • Have all pertinent information available: Your beneficiary information (name, Health Insurance Claim number, date of birth, etc.), case information, and your representative's information will all be needed in your report to Medicare. It's best to have it prepared and ready to go!

If you have sustained a personal injury and are enrolled in Medicare, it can be a murky and frustrating road to receiving the settlement you are entitled to. If you are in the Waterbury area and need a personal injury attorney, contact Cummings Law Firm today; we can help get you on the right track.

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