Does Medicare Cover Auto Accidents?
The Center for Disease Control and Prevention (CDC) reports that 2 million car accidents happen each year across the United States.
Furthermore, the National Highway Transportation Safety Agency (NHTSA) added how seniors over the age of 65 account for 9.8% of all driver injuries.
The challenge is how to pay for the medical treatment of your injuries when the car insurance company requires a court decision to determine the responsible party.
TRADITIONAL PERSONAL INJURY PROTECTION (PIP)
#1. Auto insurance PIP coverage
Before you ask Medicare to pay for the medical costs from the car accidents, find out if your car insurance covers the healthcare related expenses for the crash.
In most cases, they will when you file a claim. Even if you are the victim, you might need to file a claim with your insurance company until the other party’s insurance pays.
#2. Doctor Lien
If you cannot get either insurance company to pay for your healthcare costs up front, then you can ask the doctor or facility to place a lien on the visits.
The doctor forgoes immediate payment for the eventual insurance coverage for the visits. The caveat is if the insurance company decides not to cover your stay, you are liable for those expenses.
The other downside to a doctor lien is that providers charge the full billing rates when they work on patients who use a loan compared to those who go through insurance.
WHAT DOES MEDICARE COVER?
If you are over the age of 65 and on Medicare, then here is a list of what the government covers and does not cover. Check with your plan for long-term items like therapy, chiropractic care, and prescription drugs before you use them.
For example, you need to find out if Medicare covers chiropractic care concerning your accident. They do have coverage for it, but you might need to get a medical note from a doctor. Otherwise, you need to pay out-of-pocket until the settlement.
Medicare should cover items like a visit to a specialist, MRI, or an ER visit. Remember that they expect their money back at the successful conclusion of your case. Contact us today if you have any questions about how this would work.
#1. Emergency Treatments
Fortunately, Part B covers 80% of most emergency ambulance transportation to a close facility. That means you would be responsible for the 20% deductible.
Part B also pays for a lot of the treatments in the emergency room should you need it, and any x-rays or other diagnostic tests you need while in the emergency room.
#2. Inpatient Care
Part A often covers inpatient care as well. Check how specific parts of inpatient care work.
For example, If you need an arm, leg, back, or neck brace it is covered under Part B as long as the doctor and medical facility participate in Medicare.
#3. Physical and Speech Therapy
In 2017, Part Bused to have a cap of $2,080 for physical and speech-language therapy. However, Congress removed the cap in February. Instead, they now do a targeted review whenever therapy claims exceed $3,000 per patient.
#4. Chiropractic Care
As we discussed above, Medicare Part B covers chiropractic care. Check with your plan coverage before you see a chiropractor.
#5. Prescription Drugs
Medicare Part D covers prescription drugs. If you need to take pain relievers, muscle relaxers, or antibiotics, then you need to have Part D on your Medicare plan.
#6. Cosmetic Surgery
Cosmetic surgery must be related to the car accident and can be covered under the original Medicare as long as you pay your deductible and coinsurance payments.
#7. Mental health care
Mental health care includes outpatient visits with psychiatrists, psychologists, social workers, nurse practitioners, or physician assistants. Medicare covers this after you pay your annual deductible.
You then pay the coinsurance to cover the remaining visit costs.
As you see above, Medicare covers a hefty portion of your car accident.
However, they are aggressive about being repaid the amount they paid for a car accident. The settlement you receive would require you to pay them back as part of the monies you receive.
If you are over the age of 65, then Medicare might be a good option to pay for your car crash until the settlement.
However, if you’re need help understanding how Medicare would work with your car accident settlement, contact our Carlsbad personal injury law firm to make sure you follow the correct steps to get the most out of your settlement.
Schedule a free consultation with Levinson law by calling us at (760) 642-5475.