When Is Contesting a Medicare Demand Letter Successful?

 Posted on April 06, 2025 in Medicare Repayment

If you were hurt in an accident and Medicare paid for your medical care, you may later receive something called a Medicare Conditional Payment Letter or Medicare Demand Letter. These letters often, but not always, come after someone receives money from a personal injury settlement or insurance payout that is meant to cover losses from an accident that Medicare already paid for. Medicare sends these letters because it wants to be paid back for the medical care it covers related to your accident — and that can feel confusing, frustrating, or even unfair, especially if you are still recovering.

The good news is that in many cases, these demand letters can be challenged successfully. Whether you live in Rockford, Peoria, Kankakee, Southern Illinois, or even outside the state in places like Florida, New Jersey, North Carolina, Arizona, or California, you have the right to ask Medicare to review the demand and lower or even cancel the amount they are asking you to repay. You do not have to do this alone - our Illinois Medicare conditional payment letter lawyer can help.

Why Did I Get a Medicare Demand Letter?

When someone gets hurt — often in a car crash, a fall, or another kind of accident — and Medicare pays for treatment, Medicare keeps track of those payments. If that person later receives money from a lawsuit or insurance settlement, Medicare wants to be reimbursed for the treatment it already paid for. This is called a conditional payment, and it is "conditional" because Medicare pays for incidents like these on the condition that it might be paid back later.

Can I Challenge the Amount Medicare Wants?

Yes, and in many cases, it makes sense to do so. Here are some situations where contesting a Medicare demand letter may lead to a lower repayment — or no repayment at all:

Medicare Paid for Treatment That Was Not Related to the Accident

Sometimes, Medicare includes unrelated charges in the letter, like treatments for old injuries or medical conditions that were not caused by the accident. If that happens, the amount can be corrected.

Your Settlement Was Small

Medicare cannot take more money than what you actually received after attorney fees and costs are paid. If your settlement was much less than your medical bills, you may be able to ask Medicare to reduce the amount they want back.

You Were Not Fully Compensated for Pain and Suffering

If the settlement did not fully cover your pain, lost wages, or future medical care, Medicare may agree to accept less — especially if your lawyer can show that the settlement was limited and you still have other losses.

You Already Paid Some of the Bills Yourself

If you paid for treatment out-of-pocket or through another insurance plan, Medicare may have billed you twice. This can be corrected by showing proof of payment.

How Much Time Do I Have to Fight a Medicare Repayment Letter? 

Once you get the final demand letter from Medicare, you usually have 60 days to repay the amount or request a review. Waiting too long can result in interest charges or even garnishment of future benefits.

Talk to a Nationwide Medicare Repayment Letter Attorney 

If you received a Medicare demand letter after a personal injury settlement, you do not have to figure this out alone. Our skilled Illinois Medicare demand letter lawyer serves clients all over the state, including in Peoria, Rockford, Southern Illinois, St. Louis, and Kankakee. We also serve clients in Florida, California, New Jersey, Arizona, and nationwide. We will review the letter you received from Medicare, check its accuracy, and try to reduce the amount you may have to pay. Contact The Law Offices of Joseph J. Bogdan, Inc. at 630-310-1267 for help protecting your settlement and peace of mind. We offer free consultations.