When No-Fault insurance pays for all or part of the medical expenses for injuries regardless of who may have been responsible for causing the accident, this insurance is sometimes called personal injury protection (PIP), medical payments coverage (MED PAY), or medical expense coverage. If such monies have been paid to the Medicare beneficiary and/or Medicare, the total amount paid must be entered.

Note: If Medicare has paid claims in relation to the incident, Medicare's recovery amount will be directly impacted by any amount entered in the MED/PIP/Other Exclusions field. When processing a liability settlement, the Centers for Medicare & Medicaid Services (CMS) will make a pro rata reduction based on the settlement amount, attorney's fees and expenses. When processing a no-fault settlement, there should be no reduction based on the amount the no-fault insurer has paid directly.

For example:

• A Medicare beneficiary incurs $20,000 in covered medical expenses due to an automobile accident.
• The beneficiary receives $5,000 in no-fault insurance benefits toward covered medical expenses and also has a liability claim pending against the driver of the other car.
• Medicare does not pay benefits for the $5,000 in expenses paid for by the no-fault insurer but pays conditional benefits based on the additional $15,000 in expenses.
• The Medicare payment is subject to recovery when the liability claim is paid.