How Medicare & Medicaid Affect NC Personal Injury Cases

How Medicare & Medicaid Affect NC Personal Injury Cases

Managing regular Medicare and Medicaid claims in North Carolina is complex – and even more so when you add the complication of a personal injury claim. 

This article walks through the key details of Medicare and Medicaid coverage as related to personal injury cases.

Medicare & Personal Injury Coverage

Medicare is the national health insurance program that provides coverage to people age 65 and older – as well as younger people with certain disabilities. 

If injured in a car accident caused by another driver’s negligence in North Carolina, Medicare recipients can (and should) pursue a personal injury claim to receive compensation for their injuries. 

Unfortunately, personal injury compensation generally DOES NOT arrive until several months after medical bills are due. 

That’s where Medicare Liens come in!

While Medicare may initially cover your medical costs for an injury due to a motor vehicle accident, the program will ALSO issue a medical lien – asserting its rights to reimbursement for its coverage if you win your personal injury case. 

Reporting a Personal Injury Settlement

Within 60 days of a personal injury settlement, you are required to report the judgment to Medicare (or risk paying some hefty fines – as much as $1,000 a day).

You can file your settlement report electronically on the Medicare Website. 

Although Medicare is not required to send a notification of the lien, it will generally send you letters explaining your rights and responsibilities – as well as their recovery demands.

NOTE: Review the Medicare Lien and recovery demands with your personal injury attorney to ensure there are no errors. Medicare is ONLY entitled to reimbursement for treatments and care directly caused by your personal injury.

You (or your personal injury lawyer) are legally responsible for reimbursing Medicare the requested amount. If you still believe there is an error in the lien, you can also make an appeal.

LEARN MORE: Medicare’s Recovery Process

Medicaid & Personal Injury Coverage

Medicaid is an federal-state assistance program that provides aid to low-income people of ALL ages. 

If you receive medical treatment for a personal injury, do not have health insurance (including Medicare), and cannot pay the bill, Medicaid may cover your costs. Then, the program will automatically issue a Medicaid Lien.

NOTE: It is possible to receive medical liens from BOTH Medicare and Medicaid. In such cases, Medicare will recover its lien first.

Medicaid practices vary from state to state, so it is important for you to consult with a personal injury lawyer who is familiar with the particular Medicaid statutes in North Carolina. 

Like a Medicare Lien, if you end up winning your personal injury case and recovering compensation, a Medicaid Lien will require you to reimburse Medicaid for its coverage. This process is known as subrogation.

North Carolina statutes hold your personal injury attorney liable for repaying Medicaid for its expenses before distributing any additional compensation to you. 

Robert L. Armstrong | North Carolina Personal Injury Attorney

Have you or a loved one been injured as a result of a car accident? 

Robert Louis Armstrong can help you build a strong personal injury case and navigate the complexities of Medicare and Medicaid Liens.

Contact Robert Armstrong’s office today for a FREE consultation!


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Why Medical Care is Necessary After a Car Accident

How to Tell if a Personal Injury is Serious Enough For an NC Lawsuit