Medical Liens: Do I Have To Pay Back My Medical Insurance Company?

Yes – you will have to pay back medical liens from a personal injury settlement or verdict. Many people don’t realize that once you make an injury claim, your health insurance company can be entitled to get back any money they paid for your treatment. This is called a “right of reimbursement”, and with private health insurance it is usually written into the language of the health insurance policy. Once suit is filed, your health insurance company will have what’s called a “lien” against any recovery that you get in your case for the money they paid for your medical treatment.

What if you have Medicare or Medicaid?

Both Medicare and Medicaid have their rights to reimbursements written into law – Medicaid at the federal level and Medicaid at the state level.

Additionally, Medicare’s and Medicaid’s right of reimbursement only extends to the portion of the verdict or settlement designated to compensate you for medical expenses. For example, if you have a settlement of $100,000 with $50,000 of that officially designated as being for medical expenses, Medicare can only get reimbursed from that portion.

Will my health insurer reduce the amount of their bills?

Possibly. Many health insurers are willing to reduce the amount of their liens based on a potential settlement or a verdict. Florida Medicaid has a reduction formula spelled out in statute. Medicare has its reduction formula spelled out in federal law.

Remember: the goal in any settlement should be to compensate you, and not just your health insurer, for your injuries. While your health insurer may have paid your hospital bills, you can end up bearing the costs of your injuries into the future. Metcalf Falls, Criminal Defense Attorneys, P.A.’s priority in any settlement is making sure you are fairly compensated.