Are you a mesothelioma patient who received compensation for your illness? Unfortunately, you may not be able to keep all of it. If you are eligible for Medicare and received a settlement, the government may demand reimbursement for the medical expenses that were paid on your behalf. This can come as a shock and add to the already emotional and financial stress of dealing with a serious illness. In this article, we will explore everything you need to know about receiving settlement for mesothelioma and the potential reimbursement demands from Medicare.
Introduction: Understanding the Basics of Mesothelioma Settlements and Medicare
Mesothelioma is a rare and aggressive cancer caused by exposure to asbestos. Unfortunately, it can take decades for mesothelioma symptoms to appear, often leaving patients with a poor prognosis. If you or a loved one has been diagnosed with mesothelioma, you may be eligible for compensation from the company or companies responsible for your exposure to asbestos. This compensation can help cover medical expenses, lost wages, and other damages.
Medicare, on the other hand, is a federal health insurance program that covers individuals who are 65 or older, disabled, or have a chronic kidney condition. It is often a lifeline for mesothelioma patients who may face astronomical medical costs without it. Medicare covers hospitalization, doctor visits, prescription drugs, and more.
Now, let’s explore what happens when these two programs intersect.
Mesothelioma Settlements and Medicare Reimbursement
If you receive a settlement for your mesothelioma diagnosis, you may have to pay back the amount that Medicare spent on your medical care related to the disease. This is called reimbursement, and it is required by law. Medicare has the right to recover any payments made for medical care related to a settlement. This includes payments made before and after the settlement was reached.
There are a few things to know about Medicare reimbursement:
1. What expenses does Medicare cover for mesothelioma patients?
| Type of Care | Description |
|---|---|
| Diagnostic Tests | CT scans, MRI’s, blood tests, and biopsy procedures |
| Surgery | Mesothelioma patients may need surgery to help remove tumors or alleviate symptoms |
| Radiation Therapy | Radiation can help shrink tumors and alleviate symptoms |
| Chemotherapy | Drugs can help slow or stop the growth of mesothelioma cells |
| Hospice & Palliative Care | End-of-life care to relieve pain and symptoms |
These are some of the many expenses that Medicare may cover for mesothelioma patients. If Medicare paid for any of these expenses, they may want reimbursement if you receive a settlement.
2. What is the Medicare Secondary Payer Act (MSPA)?
The MSPA is the law that requires Medicare to be the secondary payer to any other insurance, such as worker’s compensation or a judgment or settlement from a lawsuit. This means that if another insurer is responsible for the medical payments, they should pay first, and then Medicare will cover the rest. If there is a settlement, Medicare will likely want to be reimbursed for any medical expenses that were paid on your behalf.
3. How does Medicare Determine what to Recover?
When it comes to reimbursement, Medicare determines what to recover by looking at the total amount of the settlement and the total amount that was paid for medical care related to the settlement. They then calculate what percentage of the settlement should be reimbursed based on the percentage of the medical expenses that they paid.
4. Do I have to comply with Medicare’s request for reimbursement?
Yes, you must comply with Medicare’s request for reimbursement. If you do not, Medicare may refuse to pay for future medical expenses related to your mesothelioma diagnosis. This can be devastating for patients who rely on Medicare to cover the cost of their care.
5. Are there any exceptions to the reimbursement rule?
There are some exceptions to the reimbursement rule. For example, if the settlement is less than $750 and the expected cost of collection is greater than the expected recovery, Medicare may waive its right to reimbursement. If you are unsure if an exception applies to your case, it is always best to consult with an attorney.
6. How can I protect myself from reimbursement demands?
One way to protect yourself from reimbursement demands is to create a Medicare Set-Aside (MSA) account. An MSA is a portion of the settlement that is set aside specifically for future medical expenses that Medicare may pay for. By using an MSA, you can ensure that Medicare is reimbursed for any medical expenses related to your mesothelioma diagnosis, but you can also protect your settlement funds from being used to pay back Medicare.
Yes, it is essential to have an experienced attorney on your side to help you navigate the complex process of mesothelioma settlements and Medicare reimbursement. A qualified attorney can help you negotiate with Medicare, create an MSA account, and make sure that you keep as much of your settlement as possible.
FAQs: Frequently Asked Questions About Mesothelioma Settlements and Medicare Reimbursement
1. Can I still receive Medicare if I receive a settlement?
Yes, you can still receive Medicare if you receive a settlement. However, if Medicare paid for any medical expenses related to your mesothelioma diagnosis, they may demand reimbursement.
2. How long do I have to pay back Medicare?
You will have to pay back Medicare within 60 days of receiving your settlement. However, you can negotiate a repayment plan that allows you to pay off the amount owed over time.
3. How does Medicare know if I receive a settlement?
Medicare receives information about settlements and other payments from the Centers for Medicare and Medicaid Services. If you receive a settlement, the responsible party is required to notify Medicare.
4. What happens if I don’t have the money to pay back Medicare?
If you cannot pay back Medicare, they may refer your case to the United States Department of the Treasury. This can result in wage garnishment or other legal action.
5. Can I still file a lawsuit if I am on Medicare?
Yes, you can still file a lawsuit if you are on Medicare. However, it is important to understand that Medicare may demand reimbursement if you receive a settlement.
6. Can I negotiate with Medicare on the amount of reimbursement?
Yes, you can negotiate with Medicare on the amount of reimbursement. However, it is essential to have an attorney on your side to help you negotiate effectively.
7. Will I have to repay Medicare if I lose my lawsuit?
No, you will not have to repay Medicare if you lose your lawsuit.
8. What should I do if I receive a reimbursement request from Medicare?
If you receive a reimbursement request from Medicare, it is essential to seek the advice of an experienced attorney. They can help you navigate the process and negotiate with Medicare on your behalf.
9. Can I still receive Medicaid if I receive a settlement?
Yes, you can still receive Medicaid if you receive a settlement. However, like Medicare, Medicaid may demand reimbursement for any medical expenses related to your mesothelioma diagnosis.
10. What is the difference between Medicare and Medicaid?
Medicare is a federal program that covers individuals who are 65 or older, disabled, or have a chronic kidney condition. Medicaid is a joint federal-state program that provides healthcare coverage to low-income individuals and families.
11. Can I use some of my settlement to pay for non-medical expenses?
Yes, you can use some of your settlement to pay for
non-medical expenses. However, you should be aware that if Medicare paid for any medical expenses related to your mesothelioma diagnosis, they may demand reimbursement.
12. How can I make sure that my settlement funds last as long as possible?
You can make sure that your settlement funds last as long as possible by creating a budget and sticking to it. You should also consider working with a financial advisor who can help you make the most of your settlement funds.
13. Can I still appeal a reimbursement decision from Medicare?
Yes, you can appeal a reimbursement decision from Medicare. However, it is essential to have an experienced attorney on your side to help you navigate the appeals process.
Conclusion: Protect Your Settlement and Your Health
If you are a mesothelioma patient who received a settlement, it is essential to understand the potential reimbursement demands from Medicare. While it can be frustrating to have to pay back some of your settlement, there are ways to protect yourself and your settlement funds. By working with an experienced attorney and creating an MSA account, you can ensure that you keep as much of your settlement as possible while still complying with Medicare’s reimbursement requirements. Remember, your health and financial well-being are important, and you have the right to protect both.
Don’t wait until it is too late. If you have questions about mesothelioma settlements and Medicare reimbursement, contact an experienced attorney today to learn more.
Disclaimer
This article is intended for informational purposes only and should not be considered legal advice. Please consult with an attorney for legal guidance on your specific situation.
