Worker’s compensation can cause issues for those that have Medicare coverage. For instance, the burden for medical coverage for issues which were originally part of a worker’s compensation claim, can be disputed by Medicare. In fact, Medicare will often not pay for these types of injuries, and instead they will refer Medicare beneficiaries to the Medicare Secondary payer statute.
For example, if an individual was injured at their job and receives Worker’s compensation for those injuries, those injuries may cause medical problems long after the worker’s compensation payments. Once that individual is on Medicare, they should have their medical bills covered by their Medicare benefits. However, Medicare has rules which state that they should not bear the responsibility of the primary payer, which should be the employer.
There have been many legal issues with the Statue and often times, Medicare beneficiaries wait for their medical claims to be paid while the dispute plays out. The Medicare beneficiary does have some recourse. There are organizations, such as the National Alliance of Medicare Set-Aside Professionals Inc., which will assist those individuals in having their claims paid.
That organization is a non profit organization, whose sole purpose is to advocate for individuals in this situation. They will also assist previous employers that paid a worker’ compensation claim, if they should no longer be responsible for the medical bills incurred by the Medicare beneficiary.
