Are Medicare Patients Required to Pay Back Medical Costs in Personal Injury Cases? | Shapiro, Washburn & Sharp

There are many senior citizens and disabled adults who rely on Medicare to pay for their medical care. This federal health insurance coverage can be helpful if a victim suffers an accident that causes a personal injury. Under North Carolina law, every accident victim has the right to pursue damages against the party who is responsible for the incident that caused the accident, such as the at-fault driver in a car crash or property owner in a premises liability accident.

Once it is established who the at-fault party is, that party can be legally ordered to pay for the victim’s medical expenses, lost income, pain and suffering, and other losses the victim has suffered because of the injuries.




Injured accident victims covered by Medicare who are awarded damages in a personal injury claim or lawsuit are required to reimburse Medicare for those medical expenses that are related to the accident injury. It is very important to work with your personal injury attorney when it comes to this requirement because failure to do so can result in financial or even criminal punishment if you fail to abide by Medicare’s rules.

The first thing a Medicare-covered accident victim should do is to report any accidents to the Medical Coordination of Benefits Contractor. Even if a victim fails to report the accident, it is likely Medicare officials will find out about the accident by of routine monitoring of accounts. If they suddenly see doctors’ visits and treatments, officials will contact the victim to find out about the details of the injury and how it happened.

When a victim receives compensation in a settlement or award, they are required to notify Medicare since the agency has the legal right to receive compensation for what they paid out before the victim actually collects what their funds.

When you notify Medicare of your injury or they otherwise find out, they will serve you with a notice of lien that it has placed on any injury compensation you receive. Victims and their attorneys should always compare the lien amount to the amount that Medicare actually pain in medical expenses for treatment of the injury. The lien may also include treatment of future medical treatments that may be needed, so make sure to provide the lien to your attorney.

When a victim receives the final lien from Medicare, they may appeal that amount if they feel it is wrong. If no appeal is filed, the victim will have to pay the full amount. Federal laws do not allow any negotiations for lower liens with a patient such as private health insurance companies may do.

Call a North Carolina Injury Lawyer

If you have been injured in an accident caused by another party and are covered by Medicare, contact a North Carolina personal injury attorney from Shapiro & Appleton to ensure that that you not only receive the financial compensation you deserve in any settlement or award you receive but also to ensure that any reimbursement to Medicare is not more than what they should be entitled to receive back.