In what ways is Medicare involved in a Workers’ Comp Claim?

Medicare is very involved in workers’ compensation claims. The federal government does not want to pay for any medical treatment which is the responsibility of the workers’ compensation insurance carrier. Therefore, Medicare is prohibited from paying for medical services that have been or can reasonably be expected to be paid under workers’ compensation. If Medicare mistakenly pays for a claim, then Medicare has a lien. It has the right to recover 100 percent of its payments. This is one reason why it’s very important that your medical treatment is paid through the workers’ compensation insurance carrier and not your regular health insurance and definitely not through Medicare or Medicaid. This prevents Medicare from having a lien on any future settlement that you may have. If you are planning on settling your workers’ compensation claim, Medicare may have an interest regarding the funds that have been allocated towards future medical treatment. All parties are supposed to protect Medicare’s interests in any settlement. In many cases, Medicare’s written approval is required before you settle your workers’ compensation claim. The criteria and financial guidelines are subject to change by Medicare. Medicare has regulations and issues internal memorandums that give guidance to individuals on how to deal with Medicare, and I suggest you go to their website for the most up-to-date criteria.

2016-08-01T02:35:07+00:00

About the Author:

The Injured Workers Law Firm is a Richmond, Virginia based firm solely focused on serving clients with workers' compensation claims in Virginia. If you have questions about your benefits or if you would like more information on the Virginia Workers’ Compensation system, order our book, “The Ultimate Guide to Workers’ Compensation in Virginia” , or call our office today (804) 755-7755.