June 2, 2014

Question

I was injured in a car accident late last year; the other party was 100% at fault and his insurance company has accepted full liability. A rep from his insurance company has been in contact with me to settle my claim. Because I receive Medicare, they have to request a Conditional Payments Letter. I promptly faxed back a release for that, though they didn't send it to Medicare until 2 weeks later. How long does it take to get this letter from Medicare so I can settle this? I doubt the amount will be anything anyway, as I receive benefits through a Medicare Advantage Plan. Is there anything I can do to speed things up? Also, the rep said he calculated my wage loss for the accident (I work part time) but won't tell me what that is or settle that portion until hearing from Medicare.

Answer

If you're dealing with a Medicare receovery office in Ohio, they'll tell you it will take at least 6 weeks, but it can often take much longer. Unfortunately, many insurance companies will withhold payment of a settlement until you send them the letter. Some will accept a 'hold harmless' agreement when the injured person is not medicare-eligible, and since the Federal Govt. in its wisdom puts the onus on the injured party and their lawyer to make sure Medicare is not owed anything, the insurance companies are happy to make you wait.


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