Workers’ Compensation pays for health care items or services related to job-related illness or injury.
Medicare generally does not pay for injuries or illnesses/diseases covered by workers’ compensation. A claim may be filed with Medicare if workers’ compensation denies all or part of it because it is not covered.
The Medicare program may pay a claim for a medical service or product covered by Medicare if workers’ compensation does not cover the claim. When parties settle a workers’ compensation claim, they should consider Medicare’s interests related to future medical services and whether they want to include a Workers’ Compensation Medicare Set-aside Arrangement (WCMSA).