In this article, I answer the question “Does Medicare cover injury to me in the event of a Florida motorcycle accident?
My present insurance company says liability for passenger only. My car and truck insurance has uninsured motorist coverage (UM) of 100/300k stacked which they say will cover medical for my bike although the bike is not insured through them.
I have additional medical coverage on my motorcycle but it is quite expensive. I am trying to determine if I really need that additional medical coverage. I live in Florida.”
Medicare (CMS) wrote a good article that gives a great discusses when it will pay for accident related medical bills. That article applies to motorcycle accidents, car accidents and all types of accidents.
That article also discusses when medical providers lost their right to bill Medicare and/or the Medicare beneficiary.
Every motorcycle rider who is in an accident needs to understand the laws regarding Medicare billing. If motorcyclists understand these laws, it may put extra money in their pocket.
Don’t expect the hospital or doctor to tell you that they’ve lost their claim against your settlement because they failed to follow Medicare’s laws.
1. Does stacking Uninsured motorist coverage of your car & auto policy cover you while on a motorcycle in Florida?
If you an insured in auto insurance policy that has stacking uninsured motorist coverage, the UM coverage will pay your damages if the negligence of an uninsured motorist caused your injury while you were on a motorcycle in Florida.
Does Medicare just cover liability to a passenger – and not you – while on your motorcycle in Florida?
Medicare may cover you for medical bills in the event of a motorcycle accident. However, a hospital or other medical provider (doctor, MRI facility, lab blood work company, physical therapist, etc.) does not have to bill Medicare and can try to get paid from the liability settlement.
Medicare can also deny payment of medical bills if you have previously settled a personal injury case whereupon Medicare paid your medical expenses for the same injury. However, Medicare can only deny future payment, at most, up to the amount of the settlement.
Some hospitals do a poor job in asking the injured patient for all of their insurance information. For example, I’ve had numerous client gets treatment after an accident, and the hospital doesn’t ask them for their Medicare or Medicaid information.
The question in the beginning of this article stated that
“my present insurance company says liability for passenger only.”
I assume that your insurance company (most likely the sales agent) said that Medicare only covers liability for a passenger. Perhaps the sales agent was saying that Medicare will only pay bills if the injuries were to a passenger on your motorcycle.
If this is what he or she said, I respectfully disagree. Medicare can refuse to pay if there is a primary payer (usually other available insurance coverage) that will pay for your medical bills.
However, in every case that I have had Medicare pays the medical bills of the person involved in a motor vehicle accident and then subrogates (recoups) for the payment(s) that Medicare made.
Keep in mind that if you are at fault then your uninsured motorist coverage would not pay for medical bills.
I suspect that the policy language of your motorcycle insurance policy under the “medical payments coverage” may or will give the motorcycle insurer the right to subrogate (go after) the tortfeasor – the person, company or other entity – who caused the crash.
Do you need additional medical coverage (e.g. “medical payments” on your motorcycle) if you have Medicare and/or UM coverage in Florida?
In Florida, Medical Payments (Medpay) coverage will pay for medical bills, up to the policy limit, for the motorcycle driver and passenger.
One advantage of getting “medical payments” (Medpay) on your motorcycle, as opposed to simply relying on Medicare, is that your Florida motorcycle insurer must reduce its right of subrogation by both attorney’s fees and costs as well as “other factors.” Florida Statute 768.76.
While Medicare will reduce its subrogation right by attorney’s fees and costs, you must fill out a waiver request in order for Medicare to consider “other factors” such as whether you were “made whole” in your case.
If you are on a motorcycle and hit by a driver who is at fault, one of the advantages of hiring an attorney for Medicare beneficiaries is that Medicare will reduce its lien by attorney’s fees or costs.
The same is true if there is med-pay coverage on the motorcycle. There are many other reasons to hire a lawyer as well.
You can argue to your health insurance company that you were not made whole if there was:
- insufficient insurance in proportion to your comparative fault, pain and suffering
- there are causation issues (difficulty proving that the crash caused your injuries)
- your medical bills are large in proportion to the liability insurance coverage
- you will need future medical treatment and the list goes on.
The last thing that I would want is for you to later come back and tell me that I advised you to not purchase medical payments coverage and be bothered with me. So for the record, I am not telling you not to purchase “medical payments” coverage. You should speak with a lawyer and insurance agent about whether you should purchase medical payments coverage.
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Editor’s Note: This post was originally published in March 2013 and has been completely revamped and updated.