Does Medicare Cover Auto Accident Injuries?

Medicare may help cover auto accident injuries, but Medicare may pay after your car insurance company.

If you are in a car accident and suffer injuries that are covered by your car insurance carrier, they may pay their share of your covered costs.

If the treatment for your injuries is also covered by Medicare, Medicare may help cover some of the remaining costs after your car insurance company pays first.

If you have a Medicare Advantage (Part C) plan, any treatment that would be covered by Original Medicare (Part A and Part B) will be covered by your Medicare Advantage plan.

A woman helps a man get out of a red car

Medicare Part A vs. Part B

Original Medicare is made up of two parts: Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Each part of Medicare covers different things.

Examples of the services that Medicare Part A helps cover include:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Hospice care
  • Inpatient care in a skilled nursing facility

If you are admitted to the hospital due to your auto accident injuries, Medicare Part A may help cover your hospital stay and certain inpatient care costs.

Examples of the services that Medicare Part B helps cover include:

  • Medically necessary services, including ambulance services and doctor’s services/supplies that are needed to diagnose or treat a medical condition

  • Preventive services, including clinical research and routine check-ups

If your auto accident injuries require any doctor’s services, including an ambulance ride, these costs may be covered by Part B.

Some auto accident injury bills may be denied by your car insurance company. In this case, Medicare may help pay for covered services, and you are responsible for payment on any services that aren’t covered by Medicare.

How much does Medicare Part A and Part B cost?

Even if Medicare covers your auto accident injuries, you will likely need to pay part of the costs.

Your Medicare Part A out-of-pocket costs can include:

  • Medicare Part A deductible:  $1,364 per benefit period in 2019

  • Medicare Part A coinsurance:
    • Days 1-60 spent in the hospital: $0 coinsurance for each benefit period
    • Days 61-90: $341 coinsurance per day of each benefit period in 2019
    • Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period in 2019
    • Beyond lifetime reserve days: you pay all costs

Your Part A deductible must be paid before Medicare Part A will begin paying its share of covered services.

Your Medicare Part B out-of-pocket costs can include:

  • Medicare Part B deductible: $185 per year in 2019

  • Medicare Part B coinsurance: You typically pay 20 percent of the Medicare-approved amount for most doctor’s services after your Part B deductible is met, and Medicare pays 80 percent

Medicare Part C may help pay for your treatment for qualified injuries

Medicare Part C plans are sold by private insurers as an alternative to Original Medicare.

When you enroll in a Medicare Advantage plan, you still get all of the hospital and medical benefits provided by Medicare Part A and Part B.

Therefore, your auto accident injuries will be covered by Medicare Advantage if they are covered by Original Medicare.

In addition to these Original Medicare benefits, many Medicare Advantage plans include prescription drug coverage. Some plans also offer benefits such as vision, dental and hearing coverage.

Learn more by calling to speak to a licensed insurance agent who can also help you compare Medicare Advantage plans available in your area.

 

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