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Medical Health Coverage: Repaying Liens on Your Personal Injury Settlement...

Depending on your medical health coverage, you might have to repay a lien.

In the previous section on liens, we said that shouldn’t spend your whole settlement right away. Set aside whatever money was spent on medical bills, then wait to see if a lien is requested.

You're not expected to voluntarily repay your medical health coverage provider. To get their money back, your insurance company will have to contact you first.

Of course, they may have formally requested the lien against your personal injury settlement the moment they paid your medical bills. In that case you may immediately have to send them a check.

If your medical health coverage is through an HMO, you can often get away with repaying only a partial lien. Most private types of health care coverage, your own insurance company for instance, probably wouldn't allow this kind of partial repayment.

The process of partial lien repayment involves a few phone calls and some further negotiations. An HMO provider is usually willing to listen to you in these cases. They know that if it wasn’t for your trouble in pursuing the claim, they never would have gotten any money back at all. So, in a way, your injury settlement is actually doing them a favor.

You do have some leverage against HMO health coverage. There's no definitive way to determine how much of your personal injury settlement was for medical bills and how much was for pain and suffering.

So, if the total settlement was five times greater than the bills, you don’t have much room to negotiate. But, if the settlement was only two or three times the medical bills, you can argue that the medical bills were only partly covered, leaving the rest for your other damages.

Most HMOs have a policy in place that's prepared for this type of negotiation. This means that when you contact them they'll put you in touch with whoever handles their medical health coverage liens.

They're probably aware of all the arguments you'll make against paying the full lien. Make those points anyway, it definitely won’t hurt you.

If your health care coverage is through Medicare, then the wheels will turn much more slowly. As with any government organization, things can get lost in the shuffle and cases can take longer to be reviewed - but they are less likely to request a lien.

If they do, there are usually provisions in place that automatically deduct a certain percentage of the bills. So no matter what your total personal injury settlement was, they'll only request that amount (e.g. only 75% of the medical bills have to be repaid).



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