Medicare and Your Auto Accident Injury Claim

 

In general, the way auto injury claims work in North Carolina is that they hit you, you get treatment, then their insurance pays you for your losses.  Easy peasy, right?  Well, it’s not that simple, and if you have Medicare, it’s way more complicated.

When you have Medicare, they should pay for your treatment.  Don’t let the hospital tell you they can’t/won’t bill them.  They should take your health insurance, whether it’s Medicare or not!

But it gets even more complicated.  When negotiating the settlement of you claim, you need to take into account what Medicare is going to want back.  That’s right, you’re going to have to pay something out of your settlement to Medicare after you settle the claim.

Early in your claim, you should (or your attorney should) send a letter to Medicare asking them for a Conditional Payment amount.  This can take months, so the sooner you ask the better.  This is the amount you use for negotiation purposes to determine what you’ll have to pay them back from the settlement.

This will sound backwards, I know, but bear with me.  AFTER you settle the case, yes, AFTER you settle the case, you THEN ask Medicare for their Final Payment amount, which is the amount they really do want back.  It’s normally less than the Conditional Payment number, but doesn’t have to be.  Medicare does take into account the cost of recovery (attorney’s fees, etc.), so that helps.

In a nutshell, it’s complicated, which is why you should seek competent legal representation.  Call a personal injury lawyer. Heck, call me!  919-929-2992.

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Jeffrey Allen Howard, Attorney at Law, PLLC
1829 E. Franklin St. - Bldg 600
Chapel Hill, NC 27514

(P) 919-929-2992
(F) 919-636-4779

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