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What Is Medicare Compensation Recovery?

By 10 February 2022News & Articles
Medicare Compensation Recovery

If you are injured in an accident and are making a claim for compensation, you can still claim on Medicare for the costs of seeing bulk billing doctors, and in some cases physiotherapists and psychologists. But if the compensation claim is settled for more than $5,000, you must repay all accident-related medical expenses claimed on Medicare on settlement of your case. This process is known as Medicare compensation recovery.

Here’s how the team at GC Law helps you with this:


Obtaining a Medicare Benefits List

Before settlement of the claim, we ask Medicare to issue you with a list of benefits claimed on Medicare since the date of the accident. In order to calculate the amount you need to repay on your Medicare compensation recovery, you must indicate on the list which of those Medicare payments were accident-related, and you must verify the list by signing a statutory declaration.

You can find the Medicare benefits list history statement request form here.


What is a Medicare Statutory Declaration?

Statutory declaration forms are used to prove the existence of a fact or facts. They typically include your name, address, occupation and the statement you wish to make. Within the application of Medicare, a statutory declaration is used to prove that the payments you received for your injuries on your benefits list were indeed accident related.

We then send the verified list back to Medicare, and they will issue a Notice of Past Benefits.


What is a Medicare Notice of Past Benefits?

This notice sets out the total amount you have to repay the Commonwealth on settlement. The Notice of Past Benefits details the services that you’ve told Medicare relate to your injury and the amount you’ll need to repay from your compensation.

The Notice of Past Benefits is current for six months before it has to be renewed. This enables the Commonwealth to capture any new accident-related benefits that may have been claimed on Medicare since the previous Notice of Past Benefits was issued.

Sometimes a claim will be settled on a date after a current Notice of Past Benefits has expired, but before the notice can be updated. In these circumstances, the insurance company may pay 10 per cent of the gross settlement amount direct to the Commonwealth. Medicare then calculates the total owing once they’ve received an updated list of benefits verified by you, and refunds the difference between the 10 per cent and the refund direct to you. This is commonly referred to as the 10 per cent advance payment option, but payment of the refund can sometimes take months.

You can find more details about Medicare’s Notice of Past Benefits here.


What is a Medicare Compensation Recovery Notice of Settlement?

This form is used to inform Medicare about any settlements you receive after a compensation claim. The Notice of Settlement Form must be sent to Services Australia within 28 days of the settlement date otherwise you can be liable for any outstanding payments owed to the Commonwealth.

The compensation payer or your solicitor must complete this form.

You can find more details about the Medicare Compensation Recovery Notice of Settlement form here.


How can GC Law assist in the Medicare Compensation Recovery process?

At GC Law we always endeavour to have a current Notice of Past Benefits at the date of every settlement. This ensures you get all of your money in one go, rather than the majority on settlement and the balance from Medicare—sometimes months later.

If you’re unsure what to do regarding Medicare compensation recovery, the GC Law team has years of experience helping Queenslanders settle compensation claims. You can read more about repaying Medicare here or call us at GC Law on 1300 302 318 to discuss your case. We’re compensation lawyers and personal injury specialists and we can assist you with your claim.


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