What Do You Mean My Personal Injury Case Has A Lien?
You may have heard the word lien. According to Black’s Law Dictionary, a “lien” is a legal right or interest that a creditor has in another’s property, usually until a debt or duty it secures is satisfied. “Liens” can arise in several different ways in your case. The most common way that we see liens is a health insurance lien. Although Virginia has a state law that health insurance plans are barred from subrogation, there are exceptions to that. Those exceptions are Medicaid insurance plans, health plans that are ERISA self-funded plans, Medicare insurance plans (including Medicare Advantage Plans), FEHBA plans and Tricare plans.
I Have Medicaid. Will I Have to Pay Medicaid Back After I Get Money From My Personal Injury Claim?
Medicaid plans are typically provided to a person based upon their economic need/their income. The good thing about Medicaid plans is that their reimbursement rates are very low. By law, a medical provider that submits a bill to Medicaid must accept Medicaid’s reimbursement rate. In most instances this is a substantial discount from the retail charges seen on your bill.
I’m Over Age 65 and Have Medicare. Will Medicare Take All Of The Money If I Win My Lawsuit?
Medicare plans are typically provided for people aged 65 or older. However, in some cases, a person can be on social security disability and be insured by Medicare and Medicaid. By law, a medical provider that submits a bill to Medicare must accept Medicare’s reimbursement rate. In most instances this is a substantial discount from the retail charge seen on your bill. You have heard of Medicare Advantage plans (probably on TV). These plans are given the same reimbursement rights as Medicare plans.
I Have Health Coverage Through My Employer. How Do I Know If I Have To Reimburse My Health Insurance After Settling My Personal Injury Claim?
ERISA is federal legislation that may apply to some corporate health plans. If a corporation forms its health plans under the laws of ERISA, and meets its filing requirements and is self-funded, then the ERISA plan is entitled to get its payments you’re your medical bills back from your settlement. Unlike Medicare and Medicaid, we have seen some ERISA plans pay the full amount of the bill, and in some rare cases, the plan actually contracted to pay more than the full amount of the medical bill! That just shows how poor of a negotiator the plan administrator, or its negotiator was!
ERISA plans can be costly to set up and administer and they are usually seen only for employers that have more than 50 employees. We see these ERISA plans for large employers or those with employees nationwide or worldwide. Your attorney should be knowledgeable about ERISA plans and should always verify that the plan is actually self-funded. We have had success in proving some plans were not self-funded, and we have been able to legally avoid paying tens of thousands of dollars in claimed liens.
I’m A Federal Employee, Will I Have To Pay My Health Insurance Carrier Back After Obtaining Money From A Personal Injury Lawsuit?
FEHBA is the Federal Employees Health Benefits Act. If you or your spouse (or if you are on a parent’s health plan still) is a government employee, then they likely have their insurance through FEHBA. FEHBA plans are entitled to reimbursement.
If you’re an armed services member or you are on the health plan of an armed services member then you likely have Tricare. Tricare plans are entitled to reimbursement.
I Do Not Have Any Health Insurance. Will I Have Liens On My Personal Injury Case?
The other lien that you may see is that from your medical provider. If you have no health insurance or have co-pays or deductibles, the health provider may claim a lien for those. Those are limited in dollar amount by statute, but that limitation does not mean that it caps the money you owe. It just means that is the maximum that can be withheld from your settlement, assuming a valid lien has been provided to your attorney. The provider may still sue you for the amount in excess of statutory minimum lien, if its lien exceeds that figure.
Do You Need Help With Your Personal Injury Case?
If you are navigating the world of bodily injury claims, insurance adjustors, medical providers, billings statements, liens, negotiations, case values and EOBs after an accident that was not your fault, call The Thomson Law Firm for a FREE consultation.
Virginia Personal Injury Lawyer Paul Thomson of The Thomson Law Firm has represented hundreds of car accident victims. Check out his results here.
