Oh…What about Medicare Advantage subrogation?

And you thought I had forgotten about this.

Back to the US Code.  1395w-22(a)(4) and 1395mm(e)(4) and read.  These two sections of the code appear to give the Medicare Advantage organizations similar subrogation rights as Medicare has, however you need to check in your particular state as there is some case law that does not necessarily agree with subrogation rights. 

If CMS is written to verify a subrogation amount owed, they will advise that there is no amount owed.  The Medicare Advantage organizations are independent of Medicare.  Contact needs to be made directly with the Medicare Advantage company.  Again it is up to the insurance company and or plaintiff attorney to do this. 

Again if the insurance company pays without protecting the Medicare Advantage company, they may end up paying again. 

If the actual amount owed is not known, settle the claim with the Medicare Advantage company’s name on the check or set up an escrow. 

If a person is 65 or older there is a good chance that they have either Medicare or Medicare Advantage.  If there is a medical insurance carrier listed on a bill, you can easily check the company on the internet and find out if they are Medicare Advantage.

The opinions expressed in this Blog are those of the author, based upon years working in the insurance claim industry. They are in no way to be construed as legal advice or advice with regards to Claim policies, practices or policies of any company.