Paying Back Medicare in a Personal Injury Claim
By GC Law13 Feb 2014
If you are injured in an accident and are making a claim for compensation, you can still claim on Medicare for the costs of seeing bulk billing doctors, and in some cases physiotherapists and psychologists. However, if the compensation claim is settled for over $5,000.00, then all accident related medical expenses that have been claimed on Medicare must be repaid to the Commonwealth on settlement of the case.
Before settlement of the claim, we ask Medicare to issue the client with a list of benefits claimed on Medicare since the date of the accident. The client must indicate on the list which of those Medicare payments were accident related, and the list must be verified by the client signing a statutory declaration.
The verified list is then sent back to Medicare, and a Notice of Past Benefits is issued. This is a Notice sent out by Medicare setting out the total repayable to the Commonwealth by the client on settlement.
The Notice of Past Benefits is current for 6 months before it has to be renewed. This enables the Commonwealth to capture any new accident related Medicare payments that may have been claimed on Medicare since the previous Notice of Past Benefits was issued.
Sometimes a claim will be settled on a date after a current Notice of Past Benefits has expired, but before the Notice can be updated. In these circumstances, the insurance company may pay 10% of the gross settlement amount direct to the Commonwealth. Medicare then calculates the total owing once they’ve received an updated list of benefits verified by the client, and refund the difference between the 10% and the refund direct to the client.
This is commonly referred to as the 10% advance payment option, but payment of the refund can sometimes take months.
At GC Law we always endeavour to have a current Notice of Past Benefits at the date of every settlement. This ensures that the client gets all of their many in one go, rather than the majority on settlement and the balance from Medicare, sometimes months later.
GC Law are experts in workers’ compensation claims and we are here to help you .
If you need legal advice on any personal injury claim contact GC Law now on 1300 302 318 or visit our Free Case Review page, we'll review all the details of your case and potential claim first, to determine if you have a good chance of success in claiming a compensation payout.