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Fox Lake, IL |

I was a passenger in a car accident where another 2 feet would have hit me dead on, finally settled with the ladies insurance co. being on disability at the time I had no medicare or medicare I was approved for medicare jan. 01/13 they want prove that medicare did not cover any of the hospital bills the letter was sent to medicare back in early april how long should it take for a responce from medicare? the letter I got from them said a response would take up to 65 days should we not have that by now?

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Attorney answers 4


If the letter said up to 65 days, then at least you know a letter is coming, even though it is late. We cannot answer any better than that as the letter is coming from Medicare and we cannot control Medicare.


Section 111 of the Federal Medicare, Medicaid and SCHIP Extension Act of 2007 required all insurers on car accident cases to determine whether a person making a claim is entitled to Medicare benefits on any basis. The inquiry can take up to six months, but you were told 65 days. So.... inquire when the determination will be made.


I deal with Medicare "super liens" in my practice all the time. Usually, it does take quite awhile and you have to follow up. They will first issue a conditional payment letter, then a final demand letter. Hopefully, in your case it will be zero and you can get your money. If not, you will have to deal with it.

This is another reason why having an attorney to handle these issues can be beneficial.

Stay on Medicare and follow the requirements and forms and you should get a response soon.

Stephen L. Hoffman
Law Office of Stephen L. Hoffman LLC
Chicago, IL

This answer posted on Avvo is for informational and educational purposes only. There is no attorney-client relationship created or formed and you should not rely on this as legal advice. The suggestion is made that if you wish to protect your rights, you consult with an attorney immediately.


I wrestle with Medicare too often. The Conditional Payment letter from Medicare is NOT sufficient. Any insurance company will require the "Demand for Payment" letter. It usually takes 4-6 months to get that. If any of the conditional payment letters have unrelated costs, you will have to dispute them. That will take longer. If you had an attorney, your attorney would have made this request long ago.

If this information has been helpful, please indicate by clicking the up icon. Legal Disclaimer: Mr. Candiano is licensed to practice law in Illinois and Indiana. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Links:

Stephen Laurence Hoffman

Stephen Laurence Hoffman


As Mr. Candiano points out, those of us who handle these matters act preemptively by requesting the letter from Medicare right before the case settles so it is ready to go ASAP. Again, there is no way to doped up the process once you've waited this long.

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