Can Medicare Cover Car My Accident Injuries?

Medicare and Medicaid are federal health insurance programs that will cover a variety of medical treatments for those who qualify. In most cases, they will cover at least some, and possibly all, of your medical expenses after a car accident. However, there are different types of Medicare plans, and they all have some exclusions, so you may find that some of your treatments are not covered. For instance, Medicare might decide that a specific treatment is “not medically necessary” despite your doctor’s expert opinion that it is medically necessary.

Federal and State Reimbursement for Car Accident Medical Bills

When a car accident occurs in a “fault” state like Colorado or Wyoming, the expectation is that the at-fault driver will be responsible for the damages to other people involved in the accident. Because damages like medical care can be expensive, this responsibility is usually borne by a car insurance company. (Liability insurance is required for drivers in both Colorado and Wyoming, but if an uninsured driver hits you, you may be covered by your own uninsured/underinsured motorist policy.)

Medicare and Medicaid are not car insurance policies, but because they cover medical costs in general, many people who are hurt in car crashes initially use these benefits to pay their hospital bills. This is a good solution for people who need medical care now, not a few months from now when the insurance company settles the claim.

However, the ultimate responsibility for the cost still lies with the at-fault driver/their car insurance company, so Medicare and Medicaid expect to be paid back from any settlement you receive. Under Colorado law, there is an automatic lien on any car accident settlement if Medicare or Medicaid paid some of the medical bills involved in the claim. The recipient of Medicare/Medicaid benefits for a car accident is required to notify the appropriate state agency upon receipt of a settlement for this accident.

It’s understandable if the last thing you want to do is deal with more paperwork while recovering from your injuries. Your car accident lawyer can assist you with notifying Medicare of your settlement and reimbursing them, so you will have one less thing to worry about.

What About Private Insurance?

If you have private insurance, this will also usually pay for some or all of your injuries after a car accident. Although there is no automatic lien for private insurance companies, they still have the right to seek reimbursement if you receive an accident settlement, and they will usually do so aggressively. This process is called subrogation. Again, your lawyer will help ensure the insurance company is reimbursed, and you can keep the rest of your settlement.

How Much Will Medicare Take From My Settlement?

Medicare, Medicaid, and private insurance companies are entitled to their actual costs – whatever they paid a provider for your healthcare after an accident. Your lawyer will review the medical bills with you to determine exactly what was paid by Medicare/insurance. In many cases, you may have had to pay out of pocket for some costs, and Medicare is not entitled to any money you receive for out-of-pocket expenses. Essentially, you are the party being reimbursed for these costs because you paid them.

Out-of-pocket expenses include additional costs like mobility aids, travel costs to see a specialist, physical therapy appointments not covered by Medicare, etc. If possible, save your receipts for these costs or ask the provider for a copy of your receipts.

How Long Will It Take to Settle My Car Accident Claim?

It’s hard to say without knowing more about your case. The time it takes to settle an accident claim varies widely depending on a number of factors, including:

  • The severity of the accident. If you have more serious injuries and your damages reach a higher dollar amount, chances are it will take longer to negotiate a settlement. One reason is that your lawyer will wait to settle until your treatment is complete in order to ensure you have no unaddressed medical costs. (In more severe cases where it appears that you may need long-term care, we can estimate your future medical costs.) If you had only minor injuries and recovered quickly, the process will likely go faster.
  • Disagreements about fault. In many cases, settlements take longer because the other driver claims they didn’t cause the accident, and their insurance company agrees (so they have an excuse not to pay the claim). When this happens, we will let them know all the evidence our skilled investigators have collected showing the other driver was at fault, and often this gets the discussion back on track. If not, we’re fully prepared to argue your case in court, but this will also take additional time.
  • Disagreements about the value of your claim. Like Medicare, the car insurance company might argue that some of your medical costs were not “medically necessary” or that other damages were worth less than you’re seeking. We will provide any documentation needed to show the validity of your claims, but it may take a few weeks for the insurance company to respond.
  • The speed of the court system or the insurance company’s response. Although most car accident cases are ultimately settled out of court, we often file a lawsuit to seek certain kinds of evidence in the discovery process. This means that sometimes we have to wait for a court date to argue a motion in court or wait for the other party to provide the requested evidence. We may also have to wait for the insurance company to reply to a request.

What If I Have Out-of-Pocket Costs I Can’t Afford to Pay, and the Hospital Threatens to Put Me Into Collections?

Please let your car accident lawyer know right away and provide them with any documentation – unpaid bills, threatening letters, emails, “final notices,” etc. The last thing you need while recovering from your injuries is the stress of an overzealous collections agency calling you nonstop.

In most cases, we can work out a payment or reimbursement plan with the hospital or healthcare provider. Hospitals and even collections agencies really don’t want to try to collect from someone with sound legal representation because they know their intimidation tactics don’t work on lawyers. Additionally, if they know they will be paid out of an eventual settlement, then it really isn’t worth their time and money to keep pestering you about a bill you can’t pay.

Other Potential Damages in a Car Accident Case

Medical expenses are not the only losses people experience after a car crash, although they may be the most pressing at the moment. Here are some other potential damages your lawyer will discuss with you:

  • Lost income. If your injuries prevented you from working, you are entitled to compensation for your lost earnings. This is true even if you were able to use paid sick days because those are now no longer available to you.
  • Loss of earning potential. In more severe accidents, sometimes an injured party suffers a permanent disability or chronic pain that prevents them from ever returning to work. However, you don’t have to be completely unable to work to lose money. Others may find that they have to move into a less demanding line of work that doesn’t pay as well, or that they can still work sometimes, but fewer hours than before. These situations also result in a loss of income, and you deserve to be compensated.
  • Property damage. Damage to your vehicle should be covered up to the limit of the at-fault driver’s property damage liability policy. Colorado requires a minimum of $15,000 in property damage coverage, and Wyoming requires a minimum of $20,000 (although many policyholders purchase more significant amounts).
  • Permanent disability or disfigurement. Aside from lost income concerns, any permanent disability or disfigurement can affect your quality of life.
  • Pain and suffering. A car accident can lead to extreme physical pain as well as emotional suffering or mental anguish. You have a right to seek compensation for these non-economic damages.
  • Wrongful death. If a loved one died in the accident, a wrongful death claim would allow you to seek compensation for their medical bills related to the crash, funeral and burial costs, loss of financial support, and loss of consortium or companionship.

Most of these damages will not be paid by Medicare/Medicaid and should not come out of your settlement. One exception is if you have a wrongful death claim and Medicare paid some of your loved one’s medical bills prior to their death, in which case Medicare will be reimbursed.

How Can You Get Help with a Car Accident Settlement in Colorado or Wyoming?

Please contact the Olson Law Firm for a free consultation about your case at 307-317-3374. Attorney Sean Olson founded the firm to help injured people get the compensation they need to recover and move on with their lives. He personally meets with each client, learns about their needs, and explains their options for pursuing compensation.