If you receive health insurance benefits through Medicare, you can use your Medicare coverage to pay for your medical bills following a car accident. The same is true if you receive benefits through Medicaid. But you cannot simply receive your treatment and move on with your life after an accident if you are a Medicare recipient. You must report the accident to Medicare, regardless of whether you file a personal injury claim. Medicare must be reimbursed for the money it spends on your medical treatment for an injury resulting from an accident.
However, when you work with an experienced Texas car accident lawyer at Sutliff & Stout, they can handle interactions with your assigned Medicare Coordination of Benefits (COB) contractor. These interactions will include written correspondences about your accident and all of the medical care you receive related to the injury. Your lawyer will help guide you through the process and inform you of any legal conflicts during the claim. Having an experienced individual working for your rights and intentions is crucial to your claim.
Who Pays for Medical Expenses after a Car Accident?
Following a car accident, the most important thing to know is that you are generally responsible for covering medical expenses. Even if the other person is clearly at fault, the law does not require them to pay your medical costs regularly. Part of a potential settlement may include reimbursement for doctor’s visits, surgery, or physical therapy. However, if your injuries result from someone else’s negligence, the driver may be responsible for your losses.
The Process of a Texas Car Accident Claim with Medicare Coverage
After suffering injuries and property damage in a severe car accident, you may require medical attention and other expenses to recover. The financial loss you incur due to someone else’s recklessness can feel overwhelming and frustrating. If you have Medicare, you may be questioning the next steps you should take. When you talk with your car accident lawyer about your situation, they will help guide you through the process.
Paying Back Your Settlement
After you report your accident to Medicare, they will monitor your case and the injuries you sustain. While you may believe that you can avoid this by choosing not to report your accident, Medicare will note your injury and contact you to ask if you had been in an accident. If you lie about your involvement in an accident, you could jeopardize your eligibility to continue receiving Medicare coverage.
After your case is settled, your lawyer must notify your COB contractor of the settlement amount. Your lawyer cannot disburse any settlement money to you until your COB contractor is notified of the settlement.
Negotiation with your COB Contractor
Negotiating a settlement with Medicare is difficult and time-consuming. Medicare usually likes to be reimbursed for all of your medical bills if you receive a personal injury settlement. This is also true if your case is decided in court or through a type of alternative dispute resolution.
Typically, your COB contractor will send you a statement detailing all of your medical bills after they receive your lawyer’s notification of the settlement. If the information in the statement is correct, your lawyer will try to negotiate with Medicare and then they will send a check to cover the expenses from your settlement amount before disbursing the rest of the settlement to you. While you do not have to accept what the COB says, the appeals process is complex and time-consuming, and you must follow the Medicare internal appeals process.
Medicare Liens and the Appeals Process
Medicare has a lien on your settlement, which means that it asserts the right to recover compensation for the money it spent on your medical expenses. Suppose there is a discrepancy between your COB contractor’s statement and your lawyer’s statement regarding the cost of your medical bills. In that case, your settlement money may be held this way until the issue can be resolved.
While your appeal is pending, you cannot receive your full settlement amount. Instead, you can receive the amount you would be entitled to receive based on the COB contractor’s statement about your benefits. The difference between Medicare’s figure and your figure is kept in escrow. If the appeal decision is made in Medicare’s favor, it gets to keep this money. If the decision is made in your favor, you can receive it.
Are You Eligible to Receive Compensation after a Car Accident in Texas?
While some harm and damage can never be fully reimbursed, recovering compensation for the losses you suffer due to another person’s negligence can reduce the financial burdens. A car accident attorney will not only negotiate settlement offers and discuss information with your insurance, but they can also provide you with dependable advice and representation in legal settings.
Some of the compensation you are eligible to receive include:
- Treatment and hospital bills
- Physical therapy and rehabilitation expenses
- Cost of prescription medication
- Pain and suffering
- Lost wages or income
- Property damage
- Loss of enjoyment of life
- Punitive damages
The losses you incur after a car accident can be severe and even life-threatening. If you are the primary provider of your family, the damages can affect not only you but your loved ones as well. If someone’s negligent behavior limits your ability to go about your daily life, you have the right to seek compensation for those losses.
Talk to Sutliff & Stout Injury & Accident Law Firm
We at Sutliff & Stout understand the difficulties of a car accident and how frustrating the aftermath can feel. Our team has years of experience working with clients from across Texas to receive the compensation they deserve. From talking with your insurance to representing you in legal conflicts, a lawyer at Sutliff & Stout has the tools and knowledge to offer you reliable legal services.
Call (713) 987-7111 or fill out our contact form for a free consultation with one of our attorneys today.
(713) 405-1263 
550 Post Oak Blvd, Suite 530