Articles Posted in Health Insurance Liens

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Millions of Americans have Medicare health insurance coverage.  Oftentimes however, when a Medicare beneficiary is involved in a personal injury event, dealing with Medicare can be a tedious and interminable process.

By law, Medicare has an automatic lien for any medical bills they paid out on your behalf in connection with medical treatment you received stemming from a personal injury case.  There is no way to avoid such a lien, and myself, and thousands of personal injury attorneys throughout America deal with the Medicare behemoth daily.

Therefore, if you have been injured in an accident in Massachusetts, or any other state, and you are a Medicare beneficiary, your attorney (or yourself if you are pro se) will have to work with Medicare to see to it that their lien is satisfied out of any settlement or verdict proceeds.  Because even if a case is concluded, Medicare can still pursue the beneficiary, and even the attorney, if Medicare discovers their lien was not satisfied.

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Many people in Massachusetts have health coverage through Blue Cross Blue Shield. Following a personal injury event (car accident, slip and fall, etc.) Blue Cross may pay a portion of your medical bills. If you receive a settlement at the end of your case, then Blue Cross has the legal right to obtain from you its share of money they paid to your medical providers on your behalf. This right arises from the contract of insurance that you have with Blue Cross. In my experience working with Blue Cross, they will typically reduce their lien by 10%.
Therefore, if you are involved in a personal injury accident in Massachusetts, and you have Blue Cross insurance coverage, expect to pay them back for the medical bills they paid on your behalf, out of your settlement.

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Health Insurance Liens and Your Personal Injury Case

If you have been involved in a personal injury accident in Massachusetts, and your health insurance company has paid some, or all of your medical bills relating to your accident, then they are entitled to be paid back if you receive a settlement.  The money they are paid back comes out of the settlement.

This is often referred to as a ‘lien’ or a ‘right of recovery’ that your health insurance carrier has, by law, against the money that you recover from the accident.  Often, your attorney can reduce the amount that you owe to the health insurance carrier.  Many times, the health insurance carrier will take a 1/3 reduction of their lien to reflect the attorney’s fee that you must pay out of the settlement.  At times, the 1/3 reduction of the health insurance lien can be reduced even more by your attorney.

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Many people in Massachusetts have health coverage through Blue Cross Blue Shield. Following a personal injury event (car accident, slip and fall, etc.) Blue Cross may pay a portion of your medical bills. If you receive a settlement at the end of your case, then Blue Cross has the legal right to obtain from you its share of money they paid to your medical providers on your behalf. This right arises from the contract of insurance that you have with Blue Cross. In my experience working with Blue Cross, they will typically reduce their lien by 10%.
Therefore, if you are involved in a personal injury accident in Massachusetts, and you have Blue Cross insurance coverage, expect to pay them back for the medical bills they paid on your behalf, out of your settlement.

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Many people in Massachusetts have Mass Health coverage.  For those people on Mass Health who recover compensation from a personal injury case, Mass Health has a right to be paid back.  They have a right to be paid back for medical bills they paid on behalf of the injury victim.  Many times Mass Health will reduce and negotiate their lien when an attorney is involved.  By law, Mass Health's lien is automatic and notice of the lien does not have to be provided to the injury victim, or his/her attorney in order for the lien to be enforceable. 

The insurance company that is paying the money will run a check to verify whether or not Mass Health has a lien.  If a Mass Health lien does pop up, the insurance company will either name Mass Health on the settlement check, or, will agree to not name Mass Health on the check if they are provided with a conditional release of lien issued by Mass Health.   

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Yes.   If you have been injured in a Massachusetts motor vehicle accident, slip and fall accident, or any other kind of accident, and MassHealth pays for your medical bills, they will have a lien on any monies you obtain via settlement.  A lien means MassHealth has an enforceable legal interest in money that you recover from the person or company that injured you.

However, often MassHealth will reduce their lien prior to the time of settlement.  Your Massachusetts personal injury lawyer will know how to effectively negotiate with MassHealth in order to reduce the amount of money you have to pay them.  Of course, when negotiating any lien, it is imperative to negotiate before settlement.  If negotiation occurs after settlement, your attorney does not have any negotiation leverage.   That is because MassHealth knows that the case is settled, and they will expect to be reimbursed for the money they paid out on your behalf.

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Many people in Massachusetts have health coverage through Blue Cross Blue Shield.  Following a personal injury event (car accident, slip and fall, etc.) Blue Cross may pay a portion of your medical bills.  If you receive a settlement at the end of your case, then Blue Cross has the legal right to obtain from you its share of money they paid to your medical providers on your behalf.  This right arises from the contract of insurance that you have with Blue Cross.  In my experience working with Blue Cross, they will typically reduce their lien by 10%. 

Therefore, if you are involved in a personal injury accident in Massachusetts, and you have Blue Cross insurance coverage, expect to pay them back for the medical bills they paid on your behalf, out of your settlement.

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