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Michigan Medicare and PIP No Fault Auto Insurance Changes | SES Senior Enrollment Solutions - YouTube
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(upbeat music)
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- Hi, this is John Fallot with
Senior Enrollment Solutions.
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Many of you in the State of Michigan
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have questions pertaining to your Medicare
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and the new bill that was
passed beginning July 1st,
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pertaining to your PIP,
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your personal injury protection
and no-fault insurance
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through the Michigan auto insurance.
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I'd like to go through some
questions and answers with you
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to assist some of these common questions
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to help you understand how Medicare
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and your auto insurance fits together
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to provide you the best coverage possible.
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First question, under what circumstances
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does Medicare cover accident injuries?
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Theoretically, Medicare
would cover auto accident
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related injuries without
seeking reimbursement
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only if the person had
no-fault auto insurance
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or other insurance to provide coverage.
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Next question, does Medicare
cover auto accidents
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under the new no-fault law?
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Yes, according to Insurance
Bulletin 2020-05-INS,
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which the Michigan insurance
commissioner passed in 2020,
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in the bulletin,
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the insurance commissioner
addresses the following questions
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regarding Medicare and
no-fault in Michigan.
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Will Medicare cover auto
accident-related injuries
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for a crash victim
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who opted out of no-fault
PIP medical benefits?
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Will Medicare cover auto
accident-related injuries
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for a crash victim who has reached
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his or her selected coverage
limit for no-fault PIP.
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And so both questions
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the answer is yes.
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Medicare will pay for
Medicare-covered services to enrollees
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who opt out of PIP.
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And the new law also allows
Medicare enrollees to purchase
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lower than unlimited levels
of PIP medical coverage.
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For instance, 500,000 or
250,000 per person per accident.
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Does Medicare cover auto accident injuries
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the same as no-fault?
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No.
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Medicare covers auto accident-related
injuries differently.
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This is very important.
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If you're a consumer watching this,
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you are trying to decide on what level
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of no-fault PIP coverage to choose.
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This is a big reason why
you need to be very careful
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about the idea of giving up
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auto no-fault PIP
medical benefits coverage
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in exchange for a reduced
car insurance premium.
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There are many critical medical
services and treatment areas
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that car accident victims
may desperately need
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for their care, recovery
and rehabilitation.
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These are all routinely
covered by no-fault,
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but not by Medicare.
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In fact, Medicare covers auto
accident related-injuries
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in a limited capacity.
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Here are some of the
important medical services
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that it does not cover.
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In-home attendant care,
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transportation to and
from medical appointments,
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vehicle modifications, home modifications,
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case management services,
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residential treatment programs,
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long-term and custodial
care, replacement services,
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skilled nursing facility care,
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longterm comprehensive
rehabilitation, electric wheelchairs,
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occupational therapy,
executive functioning therapy
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for post-traumatic brain injuries.
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Does Medicare cover rehabilitation
after a car accident?
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Medicare will not cover
rehabilitation services
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after a car accident in Michigan,
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as comprehensively as
no-fault auto insurance.
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Does Medicare provide coordinated coverage
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for car accidents?
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No.
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Drivers cannot coordinate
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their no-fault PIP medical
benefits coverage with Medicare
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because it is prohibited
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by the Medicare Secondary Payer law,
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which provides that Medicare won't cover
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auto accident-related
injuries when payment
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can reasonably be expected to
be made by no-fault insurance.
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How long does Medicare cover rehab
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from a car accident in Michigan?
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The answer to this
question depends on whether
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Medicare covers the
rehabilitation services
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in question at all,
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and whether Medicare has
a limit on such coverage.
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How does Medicare effect
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car accident settlements in Michigan?
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If Medicare covers auto
accident-related injuries
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that Michigan no-fault
insurance should have paid,
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then they will seek reimbursement
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for its conditional payments
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through a lien on the
pain and suffering portion
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of any car accident settlement
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that the victim obtains
in his or her case.
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Additionally, once the no-fault PIP
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medical benefit coverage
levels become available
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in policies issued on or
renewed after July 1st, 2020,
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it's possible that Medicare
may seek reimbursement
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of its conditional payments through a lien
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on a victim's third-party tort recovery
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for access medical benefits.
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If you have questions
pertaining to how your Medicare
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and your auto insurance coincide,
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please reach out to your
auto insurance carrier
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or auto insurance agent,
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or reach out to us at 877-777-5972
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or for all things Medicare,
seniorenrollmentsolutions.com.
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