Medicaid and Medicare are government-funded health insurance programs providing group-specific coverage to Americans. As a member of either healthcare plan, questions may arise regarding your insurance coverage if you’re involved in a Texas motorcycle accident.
The motorcycle accident attorneys at the Dow Law Firm have experience with motorcycle accident cases and Medicaid and Medicare coverage. A trusted Texas motorcycle accident lawyer at Dow Law Firm can assist you with exploring your available compensation options.
Does Medicaid and Medicare Cover Motorcycle Accidents in Texas?
According to the Texas Department of Transportation, 1.3 motorcycle drivers lose their lives each day on Texas roads. Motorcycle accidents are known to result in hazardous injuries, with the majority of motorcycle accident fatalities being as a result of a head injury, according to the National Highway Traffic Safety Administration (NHTSA).
If you reside in Texas and rely on Medicaid or Medicare, you may wonder if Medicaid and Medicare cover motorcycle accident costs in Texas. You’ll be pleased to learn that both Medicaid and Medicare can aid in covering medical costs resulting from motorcycle accidents.
However, there are some important factors to consider:
- Medical Necessity: Medicaid and Medicare only cover medically necessary treatments. Additional experimental treatments or procedures may not be covered.
- Eligibility: Medicare eligibility requirements depend on disability status or age, whereas Medicaid requires you to meet specific resource and income limits.
- Insurance Coordination: Medicare and Medicaid may act as secondary payers if you have additional insurance. This means they will only cover costs after your primary insurance provider has paid their share.
While Medicare and Medicaid are government-funded insurance programs designed to assist with medical costs, it’s essential to note that their coverage varies:
- Medicare: This is a federal program for those 65 years and older with specific disabilities, of which Medicare provides medical services under the following sections:
- Part A: Hospitalization expenses
- Part B: Outpatient care and doctor visits
- Part C: Prescription medications
- Medicaid: This joint state and federal government insurance program is primarily for low-income families and individuals. Texas’s Medicaid typically covers necessary medical treatments, including surgeries, hospital stays, and prescription medications. However, the insurance coverage program has strict eligibility requirements, and available coverage options may vary by individual circumstances. Additionally, it’s vital to note that Medicare typically doesn’t cover long-term care, and expenses like coinsurance and deductibles may still apply.
What About Liability and Third-Party Claims?
Suppose another driver is involved in a motorcycle accident. In that case, the driver’s liability insurance may cover your medical fees, whereas Medicare and Medicaid require you to submit a third-party claim before they consider paying out. Additionally, they might have the right to retrieve funds from you if you receive an award or settlement from the at-fault party’s insurance provider.
Are There Any Limitations or Special Requirements?
When looking at motorcycle accident claims, there are certain limitations and special requirements, which include:
- Coverage Gaps: Medicare may leave gaps in your insurance coverage, requiring the need for supplemental insurance or Medigap plans to help offset costs. Medicaid is more comprehensive for low-income groups.
- Subrogation Rights: Medicare and Medicaid can seek reimbursement for costs covered if you receive compensation from an insurance settlement or lawsuit – as mentioned above.
- Motorcycle Insurance: Motorcycle insurance in Texas is mandatory. Medicare and Medicaid may not cover costs if you are underinsured or uninsured.
Contact the Dow Law Firm for Help with Your Motorcycle Accident Claim
Medicare and Medicaid can both offer vital financial assistance for motorcycle accident injuries in Texas. However, coverage depends on third-party claims, eligibility, and medical necessity.
With the help of a Texas motorcycle accident attorney at Dow Law Firm, you can explore claim or lawsuit options. Contact us here or call us at (512) 240-9951 and let our personal injury lawyers steer you in the right direction.