How Medicare, Medicaid, and Health Insurance Impact Personal Injury Settlements In New Orleans

In this article, you can discover…

• How health insurance subrogations and liens work in Louisiana.
• How an attorney can help you navigate this complex process.
• How an attorney can help increase the money in your pocket.

Are There Any Benefits To Using Healthcare Coverage During A Personal Injury Claim In Louisiana?

Using health insurance can reduce your out-of-pocket expenses by applying contractual discounts, maximizing your recovery, particularly if the at-fault party has limited insurance. However, it can be difficult to find medical providers that will take your insurance if your injuries are from an accident.

We evaluate every aspect of available coverage, whether it be health insurance, automobile liability insurance, automobile medical pay insurance, and underinsured motorist coverage in order to maximize our clients’ recovery.

How Do Medical Liens Work In Louisiana?

First off, it is important to note the difference between Medicare, Medicaid, and private health insurance.

Government insurance plans like Medicare and Medicaid have a “super lien” on any personal injury settlement. This means that it is the responsibility of every party involved in the settlement to ensure that Medicare and Medicaid are repaid for any bills they have covered related to your injury.

Private health insurance plans, on the other hand, are only repaid if provided by contract, and even then, they may be limited if the at-fault party’s insurance is not enough to fully compensate you.

At the beginning of your representation, we will review your available policies and place government insurers on notice of any potential liens, and we will request and review any private health insurance policies, to find out what rights, if any, our client’s private health insurance has to be repaid.

All insurance liens will be resolved at the end of your case, and if you aren’t working with an attorney who is on top of these liens, your settlement may be unnecessarily delayed, or your health insurers may try to collect more than they are actually entitled to.

When you hire us, we will handle all of this for you in our efforts to maximize the outcome of your case.

How Is My Reimbursement Amount Calculated For Medicare Or Medicaid?

Medicare and any Medicare Advantage Operators, like Humana or Blue Cross, are required to reduce their lien to cover their portion of your attorney’s fees and cost. This reduction goes a long way to help maximize the amount in your pocket.

Typically, you will be expected to reimburse Medicaid dollar for dollar what they have paid on your behalf. It is possible that we can get a reduction if there is not enough money or benefits to go around, but there are already typically very low repayment rates for providers.

Because Medicare and Medicaid have “super liens” the settling insurance company will often want to put Medicare or Medicaid on the settlement check, which can substantially delay funds reaching the injured person.

When you hire us, we put Medicare and Medicaid on notice very quickly and get updated amounts routinely as your case progresses. Often, even if we do not have a final amount, the settling insurance companies will move forward with issuing payment, as they trust us to make sure all liens are satisfied.

What If My Settlement Amount Doesn’t Cover My Health Insurance Lien?

It is unlikely that we will encounter this situation, as we would never accept a settlement that was insufficient to cover a medical lien without having already negotiated any liens down on behalf of our clients. However, in the event that it happens, we will work to negotiate down any medical bills and insurance liens to make sure you, the injured person, are as fairly compensated as possible.

When you hire us, you can rest assured that we will do everything we can to maximize your take home, and, as a rule, we never take more in a fee than our client nets in settlement recovery.

Can Medicaid Or Medicare Refuse To Pay For Future Care If You Don’t Repay The Lien?

If Medicare finds out that you had a personal injury claim, you got treatment, they paid for it, and you didn’t pay them back from any settlement or judgment, that is a problem and can jeopardize your future benefits.

When you hire us, we make sure that all the i’s are dotted, and t’s are crossed so you don’t have to worry about losing the benefits to which you are entitled.

What Process Can I Expect When Dealing With Medicare or Medicaid Liens?

As soon as we are made aware of your case, we will notify the Louisiana Department of Health or any Medicare services on the federal level, as well as any Medicaid Advantage Operators and Medicare Advantage Operators that coordinate your benefits.

Prior to resolving Medicaid and Medicare, we will require them to provide an itemized list of your claims and review them alongside any bills you have to be sure everything is correct. It is not uncommon to find claims that are unrelated, so it’s important to request corrections or make any necessary appeals prior to resolving your case.

We work closely with these parties, but this can take quite some time, depending on how fast the data compilation process goes. It is best to start the process early so that your settlement is not unnecessarily delayed.

What Are Some Pitfalls That Clients Face When Dealing With Medicare, Medicaid or Private Insurance?

Many clients struggle to find a medical provider who understands that they can bill Medicare, Medicaid, or Private Insurance. Providers may assume that, in the case of an accident, they cannot bill health insurance, which is simply not true.

In fact, we sometimes have to call providers and educate them about their abilities to bill health insurance of all types. So, if the physicians’ offices who regularly work with Medicare and Medicaid have trouble understanding the process, imagine how difficult it is for the average person. This is one of the many things we can help you navigate when you work with us.

Still Have Questions? Ready To Get Started?

For more information on How Medicare, Medicaid, and Health Insurance Affect Your Personal Injury Claim In Louisiana, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling 1 504-230-5222 today.