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How Can Medicare Affect a Personal Injury Case/Settlement?

Posted in Uncategorized on June 24, 2016

Medicare is a federal health insurance program used by people 65 years of age or older, individuals with certain disabilities, and those with permanent kidney failure requiring dialysis (end-stage renal disease). Medicare helps patients cover certain health care services, such as hospital stays, hospice care, medical supplies, and some home health care. Millions of Americas use Medicare—but do you know how it could affect a personal injury claim?

Medicare and Personal Injury Law

If you are a Medicare recipient thinking about filing a personal injury claim, be aware that the law states you must repay Medicare for payments received as a result of the claim. California courts allow Medicare to take back everything it paid to you relating to the personal injury claim you make. To protect this right, Medicare automatically places a lien on any compensation you receive from them for a personal injury claim. A lien means Medicare has a legal claim to your property and can use it to pay off debt you owe if you fail to pay.

When you are dealing with a Medicare lien at the same time as a personal injury case, it can create complex problems. Medicare may place a hold on your settlement at the end of your case until you reimburse the amount. The government may even seek double the amount of its lien if you do not pay. Unlike other health care servicer providers, Medicare will rarely talk down or settle a lien for less than what you owe.

If you receive any information or correspondence from Medicare, the best thing to do is to contact an attorney for help. Handling a Medicare lien is not easy, but an experienced attorney can make it less of a hassle.

Medicare Reimbursement After Settlement

Once you receive compensation for a personal injury claim, you must report it to Medicare within 60 days. Failure to do so will result in fines up to $1,000 per day until you report your settlement or judgment. After you report your settlement, Medicare will send you a notice stating the amount you owe. You should receive this statement within 120 days of notifying Medicare.

You will receive a list of every treatment Medicare has paid for in the past. Since Medicare is only entitled to reimbursement for treatments relating to your personal injury claim, review the list of treatments and make sure they are not including any that do not qualify. If you fail to report your personal injury claim settlement to Medicare, rest assured that it will eventually find out and demand reimbursement.

Medicare is on the lookout for injuries relating to someone else’s negligence and will send notices to people when they have to pay for certain injuries—such as broken bones in a car accident. If you try to hide your settlement from Medicare in the hopes it will not know, you can jeopardize your eligibility to receive Medicare and may even be subject to criminal offense charges. Do yourself a favor: report your settlement to Medicare within your 60-day window.


Recently, lawmakers signed the Strengthening Medicare and Repaying Taxpayers Act, providing relief for taxpayers who must reimburse Medicare for treatment payments. This act reduces the time Medicare has to respond to the report you send in of your settlement or judgment. It also offers an alternative method for insured parties to provide the required information about their settlements, making the entire process less complex and more efficient.

Contact Us for More Information About Medicare and the Law

If you are dealing with a Medicare lien during a personal injury case, we can help you prevent Medicare from holding up your settlement check. We have extensive knowledge about the rules and regulations surrounding Medicare and personal injury settlements. Contact us for a free consultation about your particular settlement.

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