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. 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.
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.
Call our Baton Rouge workers’ compensation attorney at (225) 387-0293 or contact the office of J. David Smith, Attorney at Law online to schedule your free consultation.