Took care of my father for years. He has S.S and Mass Health, He has a brain tumor and has been on Disability for years, I pay for a lot in the apartment and he has no credit cards or loans, I paid his bills off years ago. After my mother died I moved in with him to keep him out of the nursing home and now I'm trying to get him back home where he wants to be. On his way home from the hospital with double pneumonia , the ambulance dropped him while on the gurney and broke a few ribs and a blood clot along with bruises. This all happened in front of his home. It's been over a year and he's still in the nursing home. I went to an appointment with him by cabulance once and said never again. It was awful. His next appointment I borrowed my friends vehicle to take him. Long story short, he doesn't own a vehicle and neither do I, I was told I could buy a vehicle and put it in both our names and I would be responsible for the Insurance and up keep, Which is fine, Our plan is for him to come back home eventually. A vehicle would be a help for getting him to his appointments and outings. Is this legal? Also can I pay for his funeral up front? And get him some new clothes shoes etc.. I have to spend this by the end of the month I'm told. I am his Health Care Provider and also his D.P.O.A.
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If so, one thing to be very VERY aware of is federal requirements of “Medicare Secondary Payor Act”. Your fathers tort attorney should know about this & held some of settlement $ in escrow like account to deal with repaying Medicare. But based on other posts this site, often the tort attorney (the lawsuit attorney for your dad), will not be at all concerned about it as it’s not out of their wallet as it’s legally your dads problem.
heres my understanding of “Secondary Payor”, for insurers- whether it’s Medicare or BlueCross - there is a requirement in your coverage that IF the insurance pays for a hospitalization or a service or a vendor; AND if later on you as the insured get a settlement AND within that settlement was bills / costs that Medicare or BlueCross paid for then Medicare or BlueCross fully expects to have those costs reimbursed or repaid to them from the settlement $. They get $ as they are a secondary payor with standing as per policy. The nonMedicare insurance companies (like BlueCross) have been better at keeping up with if there’s workman’s comp or lawsuit filed or get info from auto insurance co., from the very beginning, so they get in line by filing as attached to the lawsuit (so get settlement $ repaid first & foremost before the individual does). But Medicare really didn’t have a set system to do this, so Medicare as part of doing cost containment got a federal law passed to specifically deal with getting reimbursed from lawsuits paid.
This was done by Medicare Secondary Payor Act. It came about by law around 2010 so has been slowly creeping into being enforced with matchups by CMS (Centers for MediCARE and Medicaid) and your SS# (as it’s reported to IRS by whomever paid the settlement) and your state databases for tort settlements. If your dad was on Medicare & Medicare paid for any of his hospitalization, etc. and those costs were included in his lawsuit, Medicare will want to be repaid from settlement. Please please in writing contact the lawsuit attorney to clearly see if this happened. If you don’t get anywhere with the attorney, you can contact CMS to see if Medicare was repaid.
If he / you spend $ from the settlement that actually needs to be paid to Medicare, the required $$$ reimbursement to Medicare will surface eventually.
Medicare can suspend his eligibility till the $ gets resolved. Really you do not want to ever get the situation be at that point. He sounds like he has significant health issues & needs to be always ok for Medicare coverage. Please please make sure all is ok for MediCARE required reimbursement if his settlement included items under Secondary Payor Act.
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