Does Medicare Pay for Injuries From an Auto Accident?

If you are a Medicare recipient, you can use your health benefits to pay for auto accident injuries. But a couple of stipulations apply:

  1. Medicare is a secondary payer to your auto insurance company. In other words, it will not pay until you have exhausted your coverage through your car insurance.
  2. If you receive a settlement from the at-fault driver for your injuries, Medicare expects reimbursement for the money it paid out on your behalf.

For these reasons, if you are injured in a car accident and think you will need to use your Medicare benefits to pay for your injuries, we recommend speaking with a lawyer for help filing a car insurance claim.

S. Burke Law fights for the rights of auto accident victims. Before becoming an attorney and opening the firm, Sheryl Burke worked as an insurance adjuster, giving her an inside look at the tactics insurance companies use when dealing with accident victims. When representing clients, she frequently calls on her experience and knowledge to anticipate insurers' efforts to deny claims or pay less than the injured person deserves.

Who pays for my car accident injuries, Medicare or my auto insurance policy?

Depending on the extent of your injuries, it might be only your auto insurance policy that pays, or it could be a combination of your auto insurance policy and Medicare. The one thing that never happens is Medicare paying before your auto insurance policy does. That is because Medicare is a secondary payer; it kicks in only when you cap out other insurance coverage.

Do I have to reimburse Medicare if I receive a settlement for my injuries?

Unfortunately, in most cases Medicare requires that you reimburse them if you later receive a settlement for your auto accident injuries. In fact, they can even place a lien on your settlement.

Exemption for Pain and Suffering Damages

Medicare cannot lay claim to pain and suffering damages allocated within your settlement. However, the court, not your attorney, must specify that the compensation is for pain and suffering.

Let's return to the original example one more time. Suppose the $250,000 settlement you are awarded is not all for medical bills. Instead, $200,000 of it is awarded due to pain and suffering. In this scenario, Medicare would not be able to lay claim to the pain and suffering portion of your settlement and would only be able to place a lien on the remaining $50,000 allocated to medical bills. Thus, you would receive $200,000 of your settlement – equal to the full amount awarded for pain and suffering.

The reimbursement process can be complicated, and disagreements often arise between accident victims and Medicare as to what costs must be repaid. For this reason, it is wise to speak with an attorney from S. Burke Law before agreeing to anything with Medicare. We can take over the negotiation process and potentially win you a bigger portion of your settlement.

Still Have Questions? Call 404-842-7838 to Speak With an Auto Accident Lawyer

If you have further questions about how Medicare pays for your auto accident injuries and what happens afterward, an attorney from S. Burke Law can sit down with you and talk you through what to expect. We can intervene with Medicare on your behalf to potentially reduce the amount of your settlement that has to be reimbursed. Every case is unique. For more information, call our office today and set up a free consultation. We look forward to meeting you. Call 404-842-7838.