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What are Medicare Conditional Payments?

Dec. 8, 2020

Woman on a hospital bed with mask being held up to her face If you are a Medicare recipient and were suffered an injury to do another person's negligence, you may have heard of Medicare Conditional Payments. Under federal law, when Medicare pays medical expenses related to injuries caused by a third party, these payments are considered “conditional.” That is, if you receive compensation for the injury, such as through a settlement, judgment, or another award, Medicare has the right to recoup the payments it has made.

Therefore, if you are a Medicare recipient, it is crucial that Medicare be notified of the case. Following notice, Medicare will issue a Conditional Payments Letter. This letter lists the medical expenses that Medicare believes were related to the incident. Your personal injury attorney should check the letter against the medical bills from your treatment providers to make sure the letter is accurate. Before you agree to accept any offer of settlement, you should confirm that Medicare's rights to recovery have been considered and will be honored.