Jarrett & Price – The Lien Resource

There is a good chance that you will have to repay your healthcare plan for treatments the plan paid for that are related to your accident. That is not always the case, as it depends on what type of health insurance you use and even specific language in the healthcare plan. This is an important question for your attorney, because if and how much you have to reimburse healthcare often determines how much money you actually pocket from your settlement. The good news is even if you have to repay your plan out of the proceeds, you are still keeping more money than if you had to pay those medical bills dollar for dollar.

Private healthcare plans

Private healthcare plans are regulated by either state law or federal law. It usually depends on how the plan is funded and whether it Serves one employer or multiple employers. Federally regulated plans fall under the Employment Retirement and income Security Act (ERISA) and almost always have to be reimbursed. Other private healthcare plans fall under state regulations, and whether they have a right to reimbursement depends on that states laws. In Georgia, state law 33-24-56.1 allows plans to only be reimbursed in rare situations (if the plaintiff is “made whole” by the recovery). So when dealing with private healthcare whether you will have to repay the plan is determined by whether or not the plan is federally regulated or state regulated. Because it is sometimes difficult to know, the attorney should do some digging to find out what type of plan the client is treating with before agreeing to pay any funds.

Other rules of benefits plans have regulations that require repayment, such as Medicare, Medicaid, and Tricare. These benefit providers almost always get reimbursed. But the benefit is they are usually paying a small percentage of the total bill so the plaintiff is still saving money.

There are many types of healthcare plans. What type of plan you are using, and what the reimbursement rights for that plan, are one reason why you need an experienced attorney handling your personal injury claim.