Assuming an injured party is not a Medicare beneficiary at the time of settlement; if in the future the injured party requests Medicare benefits will Medicare provide benefits?
A42. Yes. When an injured party’s settlement does not meet both thresholds Medicare will make payment for work related medical or prescription drug charges that are otherwise reimbursable under Medicare once the injured party enrolls in Medicare. This is so, according to CMS, since CMS assumes that when a non-Medicare eligible injured party’s workers’ compensation settlement does not meet the 30-month and $250,000 thresholds, typically that injured party will completely exhaust the settlement by the time Medicare e1igibility is reached.
Related Questions
- Assuming an injured party is not a Medicare beneficiary at the time of settlement; if in the future the injured party requests Medicare benefits will Medicare provide benefits?
- Should I use the NEMB (Notice of Exclusions of Medicare Benefits) or an ABN (Advanced Beneficiary Notice) to advise the patient of financial limits "cap" on physical therapy?
- Does a beneficiary have to pay for Medicare Part D benefits?
