Repayment of Medicare Benefits

If you have made a claim for an injury or illness and claimed Medicare benefits or subsidies for medical treatment relating to that injury / illness, you will need to repay these if you receive compensation greater than $5,000.

At the beginning of your claim, you will be provided with a form called Medicare Third Party Authority Form. Once you have signed and dated the form, it will allow our office to contact Medicare on your behalf.

At the beginning of your claim, you will be provided with the following forms to complete and return to our office:

– Medicare Third Party Authority Form
– Medicare History Statement Request

Once Medicare have received the above fully-completed forms, they will send the following forms to our office for you to complete:

– Medicare History Statement
– Declaration
– Medicare Bank Details Collection Form

We require the above forms to be completed and returned to our office as soon as possible. We will advise you, in our letter enclosing the forms, of the required date of return.  

Medicare will add each benefit received that relates to your illness/injury. The items are listed in a Notice of Past Benefits and sent to us and the compensation payer. The total of this notice is the amount you will need to repay.

The Medicare History Statement Request is the first step in the Medicare process for obtaining what is known as a Notice of Past Benefits.

Once the Medicare History Statement Request is lodged with Medicare, a history statement and declaration are forwarded to our office from Medicare.

The History Statement is a complete list of all the benefits paid by Medicare within the requested period. You will be required to tick all the benefits applicable to your claim and sign the declaration. These forms must be completed and returned to Medicare within 28 days. Once the documents are lodged, Medicare will issue a Notice of Past Benefits.

The Declaration Form advises Medicare if you have received any of the following benefits or subsidies:
– Nursing home benefits
– Residential care subsidies
– Home care subsidies

Once you have returned the Medicare History Statement to our office, we will send it to Medicare. Medicare then calculates each benefit that relates to your claim and sends the Notice of Past Benefits to us and the compensation payer. This lists the total amount payable to Medicare.

The Notice of Past Benefits is only valid for 6 months. We will need to reissue a new History Statement every 6 months.

Medicare have strict timeframes. If you do not return the form in time, they will deem that all expenses relate to the illness/injury sustained. Therefore it is important to ensure you comply with the Medicare timeframes.

We will inform Medicare that a settlement/judgement has occurred.

The recent Notice of Charge is valid and the monetary amount listed will need to be paid to Medicare out of the settlement monies received.

If you do not have a valid Notice as at the date of settlement, Medicare will require 10% of settlement monies to be paid to them prior to release of any settlement funds to you. The amount will be held until you have complied with the above process and a Notice of Past Benefits issued.

If the amount of the Notice of Past Benefits is less than the 10% held, the difference will be returned to you via your nominated account. If the amount exceeds the amount held Medicare will pursue you for the balance owing.

Given the potential delay in receipt of your settlement funds, it is important to use a lawyer who is conversant with the Medicare requirements. The Law Office of Conrad Curry adhere to these requirements to ensure that your settlement monies are received in a timely manner.