ACBA
The state Bar of California
Asian American Bar Association
American Immigration Lawyers Association
ATLA
Expertise
Expertise 2021

Who Pays Your Medical Bills After a Personal Injury Accident?

Many Californians suffer personal injuries every day. Examples of these personal injuries include dog bites, slips-and-falls, car accidents and fatal accidents. You may face physical, emotional and financial burdens after such an accident. If you sustained an injury due to someone’s negligence, you might seek compensation.

However, you could already have a pile of hospital expenses that need to be paid. Typically, government healthcare services, federal or state, insure you and pay your medical bills. Yet, will Medicare or Medi-Cal cover medical bills incurred from personal injuries?

When Do You Have to Repay Medicare or Medi-Cal?

According to the Centers of Medicare and Medicaid Services (CMS), Medicare won’t pay your medical expenses if it’s possible other insurances or compensation plans will do so.

So, you may wonder who will pay your bills. Fortunately, Medicare or Medi-Cal will take care of them in some cases. For example, your public health insurance might cover your medical expenses while you’re in a personal injury dispute. Then, after you receive compensation, they could seek reimbursement.

Likewise, the California Department of Health Care Services (DHCS) states Medi-Cal requires reimbursement if they’ve paid for bills related to personal injury accidents.

Can You Appeal Your Repayment Amount?

After your personal injury settlement, you will receive a letter Medicare with the amount of money you need to repay them. However, if you disagree with the listed amount, CMS notes you have 120 days to appeal the decision.

What is a Medicare Waiver of Recovery?

A Waiver of Recovery and an appeal are different. To qualify for a Waiver of Recover, you must meet the following conditions:

  • You are not at fault for payments Medicare has made
  • It would be difficult to pay back Medicare because of your current financial situation

Personal injuries can be dangerous and costly to your pocketbook. Many Californians who suffer injuries from dog attacks, motor vehicle accidents and falls often file personal injury claims. However, a pending claim affects your Medicare or Medi-Cal coverage.

In personal injury situations, your public health insurance will only cover medical expenses conditionally, or temporarily. This means you’ll eventually have to pay them back. However, the repayment amount for both Medicare and Medi-Cal is negotiable with an attorney’s help.

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