If you are involved in an automobile accident and you are a Medicare recipient and have medical payment benefits on your automobile insurance policy, Medicare is not considered the “primary payer.”
Each coverage available to you is called a “payer.” When there’s more than one payer, Medicare’s coordination of benefits rules decide which insurance coverage will pay first. The primary payer will then pay what is owed on your bills first. Any remaining balance will be sent to the secondary payer to pay. In some cases, there may also be a third payer.
Whoever pays first will typically pay the whole bill up to the limits of the coverage. It does not always mean the primary payer pays first in time. If the insurance company does not pay the claim promptly, typically within 120 days, the medical provider may bill Medicare. If Medicare pays the bill, it is considered a “conditional payment” and Medicare has the right to recover any conditional payments that the primary payer should have made.
When a third party is involved, as in the person who caused the automobile collision, the amount of conditional payments paid by Medicare is reimbursed when the settlement for personal injuries is disbursed.
The process involved in getting your medical bills paid can be very frustrating. If you have been injured by a third party, we are here not only to handle recovering monies from the insurance company of the person at fault, but to also assist you in managing the intertwining roads involved in the bill payment process.
If you have been injured in an automobile collision and you have Medicare, the staff of Altizer Law, P.C., stand ready to help you file your claim and to help you understand the confusing and frustrating matters of who pays your bills. When you call us you will quickly see that we care about the people who turn to us for help, not just a legal claim.