If you're on Medicare and are involved in an auto accident in Michigan, the question of how your medical expenses will be paid can sometimes be a tricky one. This has been made even more complicated by the recent enactment of a no-fault law, changing the way insurance policies cover accidents. Learn more about when Medicare will (and will not) pay your medical expenses stemming from a Michigan auto accident.
What Will the No-Fault Law Change?
In states with traditional fault laws, the person who was at fault for the accident (or, in most cases, their insurance company) is responsible for making any medical or property damage payments to the accident victim. The only time a victim's own insurance policy will provide these payments is if the at-fault driver lacks insurance (in which case the victim's uninsured motorist coverage will kick in). But in a no-fault state, each motorist's own insurance policy will cover their insured's property damage and medical payments, no matter who was at fault for the accident.
Meanwhile, Medicare often doesn't cover certain critical medical services, treatments, and products that may be necessary after an auto accident. Someone who has Medicare coverage and needs transportation to and from doctor appointments, modifications to their home (like widened doorways or a wheelchair ramp), or skilled nursing care may need to pursue the cost of these treatments from their no-fault insurance company instead.
Will Medicare Cover Accident-Related Medical Expenses?
The answer is yes, under certain circumstances. Medicare may make conditional payments to cover any medical expenses that could or should have been paid by the injured person's own insurance policy, but were not. However, it will often go after the insurance company to "claw back" these expenses later by putting a lien on any settlement payments. Unfortunately for auto accident victims who receive a settlement for pain and suffering, this lien-placement process can mean the total settlement may be significantly reduced.
And under Michigan's new no-fault law, Medicare beneficiaries can opt out of no-fault personal injury protection (PIP) medical benefits or purchase a level of coverage that is lower than the state-mandated minimums. In these situations, if PIP coverage is absent or exhausted, Medicare coverage will kick in to pay costs that Medicare would normally cover, but not the above-listed costs that are generally excluded from coverage. This means that Medicare recipients may want to purchase more, rather than less insurance coverage to avoid having Medicare cover accident-related costs.
For more information on whether Medicare will pay auto accident bills in your state, contact a firm like David Helfand PA.Share