Mesothelioma Treatment and Medicare
Because it may take decades for symptoms of malignant mesothelioma to develop to the point that it can be diagnosed, it is highly likely that a person suffering from mesothelioma could be over 65. And if a mesothelioma patient is over 65, it is possible that he or she is on Medicare. But you could be eligible for Medicare benefits if you require mesothelioma treatment even if you are under 65.
Medicare is the federal government’s healthcare program intended primarily for older Americans. It covers qualifying individuals age 65 or older. But it also covers people under age 65 who are disabled and suffering from serious illnesses like mesothelioma.
When a worker who has paid a sufficient amount into the Social Security system becomes unable to hold a job for at least 12 months, he or she is eligible for Social Security disability (SSD) benefits. If you meet the criteria for disability, you could begin receiving Medicare two years after being approved for SSD.
But if you receive a personal injury legal settlement, you may have to use part of it to repay Medicare for your mesothelioma treatment. Medicare refers to their reimbursement right as a “reimbursement claim” but it is basically the same as a healthcare lien. Federal law requires all parties to “consider Medicare’s interests” in third party settlements where Medicare has made what are called “conditional payments” for injury-related care.
The term “conditional payments” describes the injury-related healthcare payments Medicare made for your mesothelioma treatment, although another party caused – and is legally responsible for – your injury. Medicare pays for your care on the condition that the responsible party’s funds will be used to pay the program back for your treatment.
A federal law called The Medicare Modernization Act of 2003 requires you and your attorney to inform Medicare that they made a “conditional payment.” Your attorney should request a conditional payment summary, then analyze, review and resolve Medicare’s claims for reimbursement. At Kazan Law, we work hard for our clients and part of that is making sure that you do not get stuck using your settlement to pay medical bills that have been inflated in anticipation of a settlement claim. When we obtain large settlements for our clients, we also see to it that they get to keep as much of it as possible by carefully examining insurance and Medicare itemized claims and medical bills, and negotiating appropriate deductions for the value of our efforts in collecting the funds so that typically our clients end up paying less than half the claimed amount.