Let’s say you suffered a back injury because of someone else’s recklessness. You decide to sue the alleged third party but during the immediate term, your medical costs are covered by Medicare. Once the case is settled, the question arises: Are you required to pay back Medicare. The answer in short is “yes.”
Who says so? The government says so. Federal law, requires that you pay back medical expenses that result from a personal injury for which some one else is to blame.
How will Medicare know? Actually the federal government is very active in investigating people who received Medicare benefits that were involved in a lawsuit.
For a person who is trying to settle a back injury claim, just dealing with the medical issues alone is overwhelming. Now add in dealing with a third-party lawsuit, dealing with workers’ compensation, your employer and Medicare, and you just may lose your mind. The mire of bureaucracy can be daunting to say the least.
What many people fail to understand is that a back injury claim settlement rarely compensates for medical expenses that are incurred after the settlement. And if you think Medicare will be there to jump in and pay for ongoing care due to a back injury or herniated disc, you’re sorely mistaken.
As it currently stands, Medicare has no obligation to pay future claims after a legal settlement. Anyone with even mild back pain symptoms knows medical care is usually required for the long term. An MRI alone can cost as much as $3,000. Back surgery can be anywhere from $40,000 to $100,000.
And even if Medicare agrees to pay future medical because of previous litigation, it could take months and or even years before they decide to pay and how much they will pay. In the meantime, the creditors will be calling and you could easily end up in bankruptcy.
The federal government needs to come to terms with this problem but I wouldn’t hold my breath. The best advice is to be aware that if you qualify for Medicare, suffer a back injury due to the negligence of a third party and decide to sue, you can forget about Medicare for immediate and long-term expenses.
Making a back injury claim is riddled with complexity, so it is in your best interest to hire an attorney to help you sort through the legal muck and mire.
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