Does the amount of my settlement have anything to do with how much Medicare will have me pay? 14 Answers as of April 11, 2013

My medical bill is about $8,000 but Medicare has reduced the amount of the condition payment. The more I get would Medicare charge me more for final payment.

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Law Office of Mark J. Leonardo
Law Office of Mark J. Leonardo | Mark Leonardo
They will reduce their lien amount based proportionally on the fees and costs you have to pay.
Answer Applies to: California
Replied: 12/5/2012
Law Offices of Mark West
Law Offices of Mark West | Mark West
If Medicare paid $8,000.00, and you get a settlement they have a lien against your settlement for that amount. It is sometimes referred to as a Super Lien as it comes before any other lien against your settlement. Generally speaking they will reduce it by a proportionate amount related to the attorney fees and costs you paid to obtain your settlement (i.e. 1/3). They sometimes reduce it further if your settlement is low, but they are entitled to the entire amount back. The bigger your settlement, the more likely it will be you will pay the 8,000.00 less the attorney fee reduction.
Answer Applies to: California
Replied: 12/5/2012
Adler Law Group, LLC
Adler Law Group, LLC | Lawrence Adler
They should not. But the less you get the more you can possibly negotiate a reduced payment to them.
Answer Applies to: Connecticut
Replied: 12/5/2012
Frank Law Group, P.C.
Frank Law Group, P.C. | Brett E. Rosenthal
Typically, the conditional payment number is normally the "Final" number, have only had a couple that changed and it was a very small percentage. While Medicare does have a process where they will consider a complete waiver depending on financial situations, they take forever in providing you a response and if the insurance carrier is not going to pay you the balance until they have the final number, I have found it is not worth the wait and have never had Medicare agree to a complete waiver.
Answer Applies to: California
Replied: 12/5/2012
Law Offices of Ronald A. Steinberg & Associates | Ronald A. Steinberg, BA, MA, JD
Possibly. They usually get no more than 1/3 of the net recovery, up to the full amount of the lien.
Answer Applies to: Michigan
Replied: 12/5/2012
    Barr, Murman & Tonelli, P.A.
    Barr, Murman & Tonelli, P.A. | Daniel P. Mitchell
    Yes, Medicare has a right of reimbursement for the moneys they have paid on your behalf. This will most definitely come out of your settlement. Usually, Medicare insists on receiving all or most of their claim out of a settlement. Ask your attorney.
    Answer Applies to: Florida
    Replied: 12/5/2012
    Lewis B. Kaplan | Lewis B. Kaplan
    No. MEDICARE reimbursement is based on what Medicare pays not on the amount of your settlement. Of course Medicare pays less than full amount of bill. But if the provider accepts Medicare assignment that limits your further responsibility to the provider. If you had a lawyer he should have explained this to you in my opinion. Also the amount you repay MEDCARE can be reduced further by a proportionate share of attorney fees and costs of litigation. You can confirm all of this by calling MEDICARE'S toll free number.
    Answer Applies to: Illinois
    Replied: 12/5/2012
    The Law Office of Stephen R. Chesley, LLC
    The Law Office of Stephen R. Chesley, LLC | Stephen R. Chesley
    No, this is a lien for medicals that has to be repaid. The settlement might increase but you would have to repay same from your share of the proceeds.
    Answer Applies to: New York
    Replied: 12/5/2012
    Dunnings Law Firm
    Dunnings Law Firm | Steven Dunnings
    Ask your attorney.
    Answer Applies to: Michigan
    Replied: 4/11/2013
    Ference & Associates LLC
    Ference & Associates LLC | Brian Samuel Malkin
    I take it that you are dealing with a workers' compensation or personal injury settlement. Under the Secondary Payer Act, Medicare is always secondarily liable to any insurance company that insures for/pay for the original injury. The conditional payment will be required to be paid back if it was related to the injury arising from the accident. Also, the question of how much extra Medicare will require is complicated legal question that requires analysis by somebody who is familiar with the laws, regulations, memorandums,and other guidances provided by CMS. You should consult with a lawyer familiar with CMS procedures because you will likely need to create a mediare set aside trust fund to comply with the Secondary Payer Act.
    Answer Applies to: Pennsylvania
    Replied: 12/5/2012
    David F. Stoddard
    David F. Stoddard | David F. Stoddard
    Normally, they would not. They cannot raise their "lien" for their conditional payment above what they actually paid in medical bills. They will normally reduce it by 25% or 1/3 for attorney's fees, which they must do. The only way they would raise what they are willing to accept to settle their lien is if they reduced it by more than attorney's fees based on your settlement being inadequate to pay them and give you a reasonable amount for pain and suffering.
    Answer Applies to: South Carolina
    Replied: 12/5/2012
    Paul Whitfield and Associates P.A.
    Paul Whitfield and Associates P.A. | Paul L. Whitfield
    Not sure I understand the question the way it is phrased but, your settlement will take into consideration how much / Medicare YOU have to pay rather than the total amount of your bills Medicare will do what it will do and that indirectly affects your settlement. You cant control any of it so why worry about it. take care of yourself, get well and make sure your lawyer has all the bills of whatsoever kind you receive.
    Answer Applies to: North Carolina
    Replied: 12/5/2012
    Andrew T. Velonis, P.C.
    Andrew T. Velonis, P.C. | Andrew Velonis
    No, Medicare wants what it wants and you get what you get.
    Answer Applies to: New York
    Replied: 12/5/2012
    Ferguson & Ferguson
    Ferguson & Ferguson | Randy W. Ferguson
    Medicare looks at what they have paid in the case and reduces normally by attorney fee and costs. If you were billed $8,000.00, the condition amount is what medicare probably paid out. They only pay a percentage of the total. They will not raise based on your settlement. I would use an attorney so it is done correct.
    Answer Applies to: Alabama
    Replied: 12/5/2012
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