Medicare is a secondary payor which means that they only pay medical bills when there is no other insurance responsible to pay the bill. In a car crash case, they pay bills only on the condition that they will be reimbursed at the end of the case. The at-fault party, not Medicare will end up paying the bills. The lien exists because the Medicare Secondary Payor Act states that when there is another source to pay bills, any payment by Medicare is a conditional payment, paid on the condition that they (Medicare) will be paid back. In a personal injury case, when the plaintiff wins, the plaintiff will pay back Medicare in full. They will pay Medicare the full amount that Medicare has paid out to pay for the plaintiff’s medical bills.
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