You have to reimburse Medicare for medical bills they paid for treatment for injuries from an accident.  Medicare has, what we call, a super lien.  Not only are you on the hook for the reimbursement but also the insurance company if they don’t pay it back would be liable.  And the attorney could also be personally liable.  You’re definitely are required to pay Medicare back anything they pay for medical care of injuries suffered in a car accident caused by someone else.

It’s much the same way with most health insurance policies.  They have provisions requiring subrogation.  You have to pay back if there is someone else that is responsible for the injury.

Sometimes the amount can be negotiated down.  Most of the time that the amount is a lot less than what your medical bills would be.  Medicare pays a very minimal amount of the total bill so if there was a $1,000.00 bill they might have only paid $122.00 toward that.  You only have to pay what Medicare actually paid.  Medicare will also give a 25 percent discount off of that for the attorney helping them collect.  The attorney usually passes this on to the client.

Medicare is a huge problem.  They are very slow in responding.  They have a lien on the case that has to be repaid.  Until the attorney gets the conditional amount from Medicare he has no idea what type of settlement or what the bottom line of the settlement will be and how much they will get.  A case in Arizona basically put a halt for two or three months on everything.  There were no letters going to attorneys stating what the lien amount was.  Consequently, car accident cases and other personal injury cases could not be settled.  This placed a huge financial hardship on those accident victims.

I was recently asked a question by a concerned mother whose daughter was in a real bad car accident.  She was driving a friend’s vehicle, but unfortunately she did not have a valid Kentucky driver’s license.  She broke her neck, broke her back, broke her arm and had five staples in her head.  Altogether she was in the hospital for about a month.  The insurance company stopped paying for her medical bills. Now she is getting all these medical bills mailed to her. Can her daughter get the remaining medical bills paid? Can she recover for her injuries even though she didn’t have a valid Kentucky driver’s license? Does she have any legal leg to stand on?  Is there anything she can do, as far as getting these medical bills paid?  Can she sue insurance company to finish paying these bills?

Let’s get to the bare bones of the law and what needs to be done. The first thing you need to realize is that you’re only entitled to $10,000.00 of medical payments under Kentucky PIP or No-Fault law. These are benefits that are paid under your cars’ Basic Reparations Benefits. Once these benefits are exhausted there’s no more money that you can get from your PIP to pay your medical bills as they are occurring.

Your next step would be to turn the remaining unpaid medical bills over to your personal health insurance. Hopefully, you have health insurance. Why should your health insurance company pay the medical bills when the injuries were caused by someone else’s negligence? This keeps the bill collectors from calling and gets the bills paid! Don’t worry; your health insurance will be reimbursed when the case is over. That is part of the damages collected from the at-fault party that caused the injuries. The bottom line is let the health insurance company pay those bills.

If you don’t have health insurance there is nothing immediate that can be done to get those medical bills paid.  The at-fault party would have to pay the medical bills when the case is settled.  That’s part of the damages that you would claim, but there’s nothing to force them pay it right now.  This is where a personal injury attorney is extremely helpful.

I would get an attorney involved in your case to look at the options with the medical bills.  A lot of times an attorney can write guarantee letters to the health care providers. This can help stop the harassing phone calls.  That would mean that you would have to pay the medical bills from the proceeds of the accident case.

The final issue in this question was the daughter did not have a valid Kentucky drivers’ license. Kentucky is a comparative fault state. This means that an injured party can still collect if they were partially to blame for their injuries. This will affect your settlement by lowering the settlement by the percentage amount you caused your injuries.  This means your wrong doing can affect your recovery.  If a jury decides that not having a valid drivers’ license was a factor that contributed to the accident, your recovery could be lowered.

The bottom line is there should be a recovery of the medical bills and a dollar amount for pain and suffering, but an experienced Kentucky personal injury attorney should review the case to make the determination.

Should Kentucky car accident victims use their personal health insurance to pay their medical bills for the treatment they receive for injuries they sustained in an automobile accident?  This is a question frequently asked by clients.

·         Do I Give my health insurance card to my doctors?

·         Why should my car insurance pay for my medical bills from an automobile accident that wasn’t my fault?

·         Isn’t it the at-fault cars’ insurance company that should have to pay?

In other words should they use their health insurance to pay for their treatment from a car accident?  The answer is no and yes. Why No? Your first and primary insurance in a car accident in Kentucky is your Personal Injury Protection or PIP benefits.  Your own car insurance will pay the first $10,000.00 of medical bills for treatment from a car accident under most circumstances. 

The “yes” comes after this $10,000.00 amount is fully paid or exhausted. You can then use your health insurance. Your health insurance will pay the medical bills from this point on.  The confusing part and what some consider the bad part about this is there’s something called subrogation. Ninety percent of all health insurance plans require you to reimburse the health insurance carrier for anything they pay toward the treatment of injuries sustained in an automobile accident. Federal ERISA laws cover this area. It is a very specialized area of law and would require pages to fully explain. Your health insurance company generally entitled to reimbursement, and they can recover what was paid out under most circumstances.

If there is a requirement to pay your health insurance company why should use your health insurance to pay the bills from your car wreck case? The answer is twofold. One is to make sure that you get the treatment you need. The second is that they pay at a reduced rate, which ultimately saves you money. Realize that you will have to reimburse them out of the proceeds of your accident case, but only what is paid.

There are some good points for the Kentucky accident victim. When a health insurance company pays a bill they will pay the provider the agreed upon price for any treatment. In other words, they will pay only a portion of the charge. You only have to reimburse the health insurance company what they have paid, not the total amount of the bill. Usually this amount will be discounted even further at the time of payment by you.

You are also responsible to pay any co-pays or deductibles to the health care provider, unless you can work out other arrangements with your doctor. You will eventually be reimbursed but that may be several months or even years later when your accident case is settled.

The bottom line is you should use your health insurance to pay your medical bills once your PIP benefits have been exhausted. Your health insurance is secondary insurance. This allows you to get the treatment you need without being hassled by bill collectors for payment.