Policy Prism AI

Federal

Beneficiary's responsibility with respect to no-fault insurance.

42 CFR § 411.51

Source text

5 segments

42 CFR § 411.51

42 CFR § 411.51

Beneficiary's responsibility with respect to no-fault insurance.

(a)

The beneficiary is responsible for taking whatever action is necessary to obtain any payment that can reasonably be expected under no-fault insurance.

(b)

Except as specified in § 411.53, Medicare does not pay until the beneficiary has exhausted his or her remedies under no-fault insurance.

(c)

Except as specified in § 411.53, Medicare does not pay for services that would have been covered by the no-fault insurance if the beneficiary had filed a proper claim.

(d)

However, if a claim is denied for reasons other than not being a proper claim, Medicare pays for the services if they are covered under Medicare.