Will Medicare pay for auto accident injuries?

In some cases it’s easy to tell what Medicare covers. For example, things like illness, disease, and common injuries are all covered by Medicare. However, what about injuries you receive in a car accident?

While it’s terrible to be injured in a car accident, the good news is that Medicare does cover auto accident injuries.

Of course, there are some coverage limits, just as there are with most other Medicare services. However, you can expect Medicare health insurance to cover your needs after an accident.

So, does Medicare cover auto accident injuries? Yes, but a Medicare Advantage or Medigap plan have extra coverage. Enter your ZIP code into our free tool today to see what quotes might look like for you.

Does Medicare cover auto accident injuries?

Medicare doesn’t so much care about how you get an injury — if it’s medically necessary to treat, you’ll be covered.

However, auto injuries can be complicated, and the American healthcare system can be hard to navigate. What exactly will Medicare pay for when it comes to auto injuries?

Medicare Part B will cover you if you need transportation by ambulance to a medical facility. With ambulance bills frequently spiking to well over $3,000, Medicare coverage is a blessing.

Part B also covers x-rays and other diagnostic tests to examine your health and determine any further treatment you might need.

If your injury is severe and you require a hospital stay, Medicare Part A will cover your inpatient treatment. This includes any surgery you need, as long as a hospital stay is involved.

Does Medicare cover auto accident aftercare?

Medicare does cover injuries from auto accidents, both directly after the accident and for ongoing recovery.

Part B covers the following services for auto injury aftercare:

• Outpatient physical therapy, including some home health services
• Doctor’s appointments to track your recovery and make future decisions
• Medical equipment, such as crutches or a wheelchair

If you need prescription medication, such as painkillers, you’ll need Part D for coverage.

Some people choose not to visit the doctor after an auto accident or go to their follow-up appointments. If you decide not to seek medical attention, you should watch for the following symptoms.

• Inexplicable fatigue
• Tingling and numbness in your arms or legs
• Neck pain
• Dizziness
• Blurred vision
• Concentration problems
• Ringing in your ears or other hearing problems
• Trouble with your memory

If you experience any of them, it’s best to call your doctor. It might be nothing, but you don’t want to gamble with your health.

How much does Medicare cost?

Each Medicare Part comes with its own costs. Original Medicare, or Parts A and B, is the base option. You can also choose a Medicare Part C (Advantage) plan, which may have an additional cost. Both Part D and Medigap plans have an extra cost.

Medicare Part A usually doesn’t come with a monthly bill. If you qualify, you get inpatient coverage for free.

However, you do have a limited amount of time you can spend in the hospital under Part A. You have a deductible of $1,484 before Medicare starts, but after that, you can spend 60 days in the hospital without paying anything.

Hopefully, you’ll never have to spend more than 60 days in the hospital. If you do, you’ll have to pay $371 per day, up to 90 days. After the 90^th day, you’ll owe $742 per day. You have 60 lifetime reserve days after a 90-day stay, and you can only use those 60 days once.

Once those reserve days are used up, you’ll have to find a new way to pay for your medical care.

Medicare Part B has a monthly cost as well as a deductible of $203 per year. After that deductible has been met, you’ll typically pay a coinsurance of 20% for any medical procedures.

Medicare Part C is also known as Medicare Advantage, and these plans  purchased from private companies. As such, the price of Medicare Advantage varies depending on what you need.

The benefit of Medicare Advantage is that you can get coverage for things that Original Medicare doesn’t, such as vision and even dental insurance.

Medicare Part D is an optional coverage you can purchase to cover prescription drugs. Part D is sold by private insurance companies, and the price you pay will depend on the pay you want. However, you’ll likely save money on your medicine.

Medigap (Medicare supplement) covers out-of-pocket costs like copays and deductibles.

Do I need personal injury protection insurance if I have Medicare?

Personal injury protection (PIP) insurance covers expenses not related to your vehicle in an accident. That includes medical bills, lost wages, and legal fees.

PIP is required in 12 states — Oregon, Utah, New York, Pennsylvania, North Dakota, Hawaii, Kansas, Michigan, Massachusetts, New Jersey, Delaware, and Florida. If you live in one of these states, you can’t opt out of PIP, even with Medicare.

However, if you live in any other state, you can skip the PIP if you’d like. It’s never a bad idea to have more coverage, though, so you should consider PIP insurance if you can afford it.

Will Medicare pay for auto accident injuries?

Nobody wants to be involved in an accident, but you can rest assured that Medicare will take care of your medical needs. If you’re worried you won’t have enough coverage through Original Medicare, you can purchase a Medicare Advantage or Medigap plan.

If you’ve been wondering, “Does Medicare cover auto accident injuries?” you can rest assured that it does. If you want to explore your Medicare Advantage options, you should start with quotes. To see what rates might look like for you, enter your ZIP code into our free tool today.

Case Studies: Medicare Coverage for Auto Accident Injuries

Case Study 1: John’s Hospitalization

John, a Medicare beneficiary, was involved in a severe car accident that resulted in multiple injuries. He required immediate medical attention and was hospitalized for several days. Medicare covered a significant portion of his hospitalization expenses, including surgeries, diagnostic tests, and medications.

However, certain specialized treatments and rehabilitation services were not fully covered by Medicare, leading to out-of-pocket expenses for John.

Case Study 2: Lisa’s Emergency Room Visit

Lisa, a Medicare beneficiary, sought medical attention at the emergency room after a car accident, and Medicare covered a significant portion of her expenses for examination, tests, and initial treatment. However, follow-up appointments with specialists and ongoing therapies incurred some out-of-pocket costs for Lisa as they were not fully covered by Medicare.

Case Study 3: Mark’s Physical Therapy

Mark, a Medicare beneficiary, suffered whiplash and back injuries in an auto accident. He required extensive physical therapy sessions to recover his mobility and manage his pain. Initially, Medicare covered a portion of Mark’s physical therapy expenses, but after a certain number of sessions, the coverage reached its limit. Mark had to bear the remaining costs for the ongoing therapy.

Case Study 4: Sarah’s Durable Medical Equipment

After a car crash, Sarah, a Medicare beneficiary, required a wheelchair due to a leg injury. While Medicare covered a portion of the cost for the durable medical equipment, Sarah still had to pay a percentage out of pocket. Furthermore, Medicare did not cover maintenance and repairs for the equipment, leading to additional expenses for Sarah.

Case Study 5: Robert’s Prescription Medications

Robert, a Medicare recipient, required prescription drugs for pain treatment and recuperation following a vehicle accident. While Medicare covered some drug costs, several prescriptions were not on the formulary or required prior authorization, resulting in partial coverage or payment denial. This motivated Robert to look into additional alternatives for ensuring proper medicine access.