If you’ve been hurt on the job, your employer’s workers’ compensation insurer is responsible for paying your medical bills in in manyl circumstances. However, complications may arise in certain situations.
Table of Contents
How Are Medical Bills Handled Under Workers’ Compensation?
What Medical Services Are Covered By Workers’ Compensation?
When Can My Medical Bills Fall Outside Workers’ Compensation Coverage?
What Happens When My Workers’ Compensation Claim Is Still Pending?
What Should I Do If I Get Billed for Workers’ Comp Treatments?
What Happens if I Have Long-Term Care Needs?
Let Farah & Farah Help With Your Workers’ Compensation Claim
How Are Medical Bills Handled Under Workers’ Compensation?
When you receive workers’ compensation benefits, your employer’s insurance company is responsible for covering reasonably necessary medical care related to your injuries. Your healthcare providers will bill the insurance company directly, so you avoid any co-pays or other out-of-pocket expenses.
What Medical Services Are Covered By Workers’ Compensation?
Workers’ compensation generally covers any reasonably necessary treatments resulting from a workplace injury, as well as related expenses. The covered costs generally include:
- Doctor’s visits and follow-up appointments
- Hospital bills
- Physical therapy and other rehabilitation care
- Prescription drug costs
- Travel expenses associated with medical treatments
If you were injured in an accident due to someone else’s negligence, Farah & Farah is here for you. We’ve relentlessly fought for the right to compensation for our clients and their families since 1979.
When Could My Medical Bills Fall Outside Workers’ Compensation Coverage?
If your workers’ comp claim has been approved, there are very few situations where your employer’s insurance won’t cover your medical bills. For instance, the insurance company might dispute whether a certain treatment is reasonably necessary or fully related to your workplace injury. In such a case, you may be able to turn to your own healthcare plan for coverage. If not, you may have to pay the expenses out of your own pocket.
Depending on state laws, you may be required to use a doctor selected by your employer or their insurer for certain treatments. If you use an unauthorized healthcare provider, the insurance company may refuse to pay for your bills from that visit.
What Happens if My Workers’ Compensation Claim Is Still Pending?
If your workers’ compensation claim hasn’t been approved yet, you may need to pay for initial medical costs through your own healthcare plan or out of pocket. Some medical providers will offer to delay payment for your care until a later date, allowing the bills to be paid properly through workers’ comp after you’ve been approved.
If you have to pay for your own medical care while waiting for approval, save copies of any bills and receipts. If your workers’ comp claim is accepted, you will be eligible for reimbursement of your out-of-pocket expenses.
Can Medicare Help Me When Workers’ Comp Coverage Is Delayed?
You might qualify for Medicare if you’re over 65 or have a qualifying disabling condition. If you are a Medicare beneficiary and a workers’ compensation claim isn’t expected to approved promptly, typically 120 days or more after your accident, Medicare may cover your healthcare expenses in the interim by making conditional payments to your providers. However, Medicare has the right to recover these payments from any settlement or award you receive. Thus, you must ensure that Medicare gets repaid once your claim is approved.
If your employer’s insurance company won’t pay for any treatments, Medicare may provide coverage if the service qualifies.
What Should I Do if I Get Billed for Workers’ Comp Treatments?
If you receive an unexpected bill for something you believe should have been covered through workers’ compensation, act quickly to determine the cause. Check your claims status with your employer or its insurer to see if there’s any stated reason why your costs weren’t covered.
“Balance billing,” a practice in which healthcare providers bill patients personally for any amount above what workers’ compensation insurance has paid, is illegal.
Whether it’s your workers’ compensation insurer or your healthcare provider, if anyone tries to wrongfully pass covered medical expenses on to you, our attorneys will fight hard to make sure you receive all the benefits you deserve.
What Happens if I Have Long-Term Care Needs?
If you have permanent, lifelong treatment needs related to your workplace injury, you may be entitled to receive continuous workers’ compensation coverage. In such situations, workers’ comp insurers will often negotiate a benefits settlement that can be paid out as a lump sum or in structured installments.
If you’re offered a workers’ compensation settlement, it’s important to consult with an experienced professional before signing anything. A trusted lawyer can look over the agreement and make sure your settlement will adequately compensate you for the expenses you’ll face for the rest of your life.
Let Farah & Farah Help With Your Workers’ Compensation Claim
If you have questions about whether your medical expenses will be covered by workers’ compensation or need assistance with your claim, the trusted workers’ compensation attorneys at Farah & Farah are here to help. Our experienced team serves workers’ comp clients in Florida, Georgia, and South Carolina.
Contact us online or call (877) 245-6707 today for a free consultation.
