Are MedPay Benefits Subject to Medicare Reimbursement?

Question: Does Medicare have a right of recovery on MedPay benefits?

Answer: If the MedPay benefits were paid directly to the medical provider (meaning the payment went to the doctor/hospital), then Medicare cannot recover for the costs of those services. Because Medicare did not make those payments, it would not have a claim for reimbursement.

But, if the MedPay benefits were paid to the claimant, then Medicare may have a reimbursement claim on the MedPay proceeds. For example, if a case settles for $100,000, and $20,000 in MedPay benefits were paid directly to the claimant, Medicare could determine that there was a total sum of $120,000, available for potential reimbursement. However, Medicare would still have to account for the procurement costs.