Gardberg & Kemmerly, P.C. Attorneys at Law


Medicare is being more aggressive than ever in seeking to get paid back the money it spends for citizens' health care. This is due in part to a set of laws known as the Medicare Secondary Payer Act. The Act was first passed in 1980, but it has been amended and strengthened in the past few years to boost Medicare's power to recover dollars it spends on health care.

Status as a "Secondary Payer" means that Medicare only has to pay for what isn't covered by other available means (primary payers), and it means that if Medicare pays for something in advance of the primary payer, it is entitled to be reimbursed.

What could this mean for you if you are a Medicare recipient? It means that Medicare might pay for your medical treatment now, but demand that you pay them back later if you get monetary compensation based on your medical treatment from another source, like an automobile liability insurance policy, a worker's compensation claim, a judgment in a court of law, or a settlement out of court. It also means that Medicare could penalize you or your representative for failing to comply with its rules of disclosure. In some cases, you might even have to set aside part of your money in a trust account to cover future medical bills so that Medicare won't have to pay them. If you accept an award without telling Medicare, or without protecting Medicare's rights, you could be at risk of losing Medicare eligibility altogether. The extent of Medicare's power under these laws is still uncertain, and details of the Act's practical application are still being worked out.

If you are ever in an accident which becomes part of an insurance claim or court case, make sure to clearly communicate with your attorney or insurance representative about your status as a Medicare recipient or Medicare applicant in order for Medicare's rights and your rights to be fully protected.

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