Information on Medicare

What you need to know about your Medicare benefits…

As discussed in the social security section, many times an injured work seeks social security benefits after they are hurt.  This can sometimes result in the injured worker becoming eligible for Medicare.

Medicare eligibility in and of itself is usually not much of an issue before settlement, as long as Medicare does not pay for medical expenses associated with the work accident.  All work accident medical care should be paid for by the workers’ compensation insurance company. 

However, if you are Medicare eligible or soon could be, any lump sum settlement of your workers’ compensation benefits will almost always have to consider Medicare’s interests.  You should think of Medicare as an insurance company run by the federal government.  It pays for your medical care because you paid into the system while you were working or became entitled to coverage due to economic factors.  Remember, Medicare always considers itself a secondary source for coverage if some other insurance source is available.  A workers’ compensation insurer is a primary insurer and Medicare will not pay for medical care that was or is the responsibility of the workers’ compensation carrier.  Medicare does not become primary just because you settle your workers’ compensation case.

If you settle your workers’ compensation case and then try to get Medicare to pay for treatment related to your work injury, Medicare may refuse to pay, leaving you without healthcare coverage for your work injuries.  Fortunately, there are strategies available to help protect your Medicare rights.  These include professional life care planning, Medicare Set Aside arrangements and some other practical tools to deal with these issues.  

It is extremely risky to settle a workers’ compensation case for a lump sum if you can reasonably expect to be eligible for Medicare, without addressing these issues. 

I would be happy to speak with you personally, on the telephone, or by email about your case.  I will explain what the insurance company owes you and why at no cost or obligation to you.  I am one phone call away.  Toll Free 1-866-712-2667 or in Baton Rouge 225-387-0293 or by email.  My firm represents injured workers all over the State of Louisiana.  Fill out this short case consultation form  and I will contact you at your convenience..