If you are 65 years of age or older and sustained an injury at your place of work, your workers’ compensation claim might be somewhat more complicated than most others since it will likely involve Medicare into the mix. Medicare is a federal health care program that provides medical benefits to individuals who are either on disability or aged 65 and over. However, workers’ compensation provides benefits to those who suffer an injury on the job. If you qualify for both benefits, can you receive them concurrently?
What You Should Know About Medicare and Workers’ Compensation
When an individual is eligible for both Medicare and another type of insurance, such as workers’ compensation, both can provide coverage for that person’s medical expenses, but they must do so according to coordination of benefit rules. These rules will decide which insurance will be the primary and secondary payer.
In the case of Medicare and workers’ compensation benefits, Medicare would be considered the secondary payer, whereas workers’ compensation would be the primary payer for the injured worker’s medical expenses that relate to the employment injury. Therefore, Medicare would not pay for any of the items or services that workers’ compensation would cover. It can, however, make conditional payments when workers’ compensation denies the payment of medical bills. It is also possible for Medicare to cover a portion of medical bills that are not covered by workers’ compensation if an injury is only partially covered.
Medicare might also affect the settlement of a workers’ compensation claim. in addition to repaying Medicare for any payments related to your claim, the settlement might also require that funds be set aside for future services related to your workers’ compensation claim that would have been covered by Medicare in a Workers’ Compensation Medicare Set Aside Arrangement (WCMSA).
Workers’ Compensation Attorneys in Orange County
If you are 65 or older and recently sustained an injury while at work, you need to secure skilled legal counsel as soon as possible to ensure your claim is handled effectively. At Alvandi Law Group, P.C., our team of workers’ compensation attorneys in Orange County is dedicated to representing injured workers to ensure they obtain the benefits they rightfully deserve. Backed by a proven track record of success, you can be confident in our ability to help you.
Get started on your case today and contact our law office at (800) 980-6905 to request your free initial case evaluation. You will not owe us any legal fees if we win your case.