Gardberg & Kemmerly, P.C. Attorneys at Law

Medicare and Settling Your Personal Injury Claim


If you are a Medicare beneficiary and have been injured through the negligence of another person, you may have to repay Medicare for benefis they paid on your behalf. However, you only have to repay Medicare if you successfully resolved your claim by either a settlement or jury verdict. Medicare subrogation rights cannot be ignored and strict penalties can be imposed on parties who have attempted to avoid repayment when necessary. Navigating the Medicare subrogation system is a difficult proces to undertake but an experienced attorney can help provide guidance.

Additionally, Medicare ("MSA's") are starting to become a major factor for plaintiffs and their counsel to consider when settling a liability claim against a tortfeasor. Medicare has taken the position that when Medicare has paid for medical benefits for a beneficiary due to the fault of a third-party, and the beneficiary also recovers medical expenses from that party, the beneficiary not only needs to repay Medicare for the benefits conferred, but must also consider the future related medical bills Medicare may pay later in the beneficiary's life. Unfortunately, the federal government has not provided a clear guideline for those that must consider protecting Medicare's future interest and pending legislation may change the current process at anytime.

It is extremely important to work with Medicare as soon as possible. Failure to consider an MSA may leave you liable for penalties and the loss of your benefits until Medicare decides it has been adequately reimbursed. Therefore, communicating with your personal injury attorney is crucial and can provide for a smooth resolution with Medicare when resolving your claim with a negligent third-party.

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