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How Do Health Insurance, Medicare, and Medicaid Come Into Play in a SC Personal Injury Case?

| Jun 28, 2010

The short answer is "very carefully." When you get into a traffic accident in South Carolina that is somebody else's fault, that person may be responsible for compensating you for your medical treatment, among other things. Many times it is beneficial to you or your doctor for the doctor to get paid immediately by your health insurance (or Medicare, Medicaid, or Workers' Compensation insurance), rather than waiting until after you have resolved your SC personal injury claim. But if you used your health insurance, Medicare and/or Medicaid to pay for your treatment AND you received monetary compensation from the at-fault driver, the law may say that you received double benefits. However, in most cases, the health insurance Medicare and/or Medicaid has a "lien" on the proceeds of your personal injury case - they have the right to get reimbursed for anything that they paid that really should have been paid by the at-fault driver.

What is a lien? A lien is a legitimate legal claim that someone else has to something that you think of as "yours". If you have a mortgage on your house, the bank has a lien on your house. If you are still making payments on your car, the dealership has a lien on your car. Liens ensure that someone who lends money to you has some way to get their money back if you cannot make the payments. In this case, the lien is good thing - it allows you to get medical treatment even if there is ultimately some problem with your personal injury case.

While the concept is simple, getting it done is far from simple. You can bet that when they are entitled to do so, that health insurance, Medicare, and Medicaid will make sure they get reimbursed. But the process can be an administrative nightmare, with forms going back and forth, months of delay, and endless debate over which medical bills were related to the accident and which ones weren't. Don't settle your South Carolina personal injury case on your own just to have the health insurance carrier, Medicare and/or Medicaid come back months or years later with a big bill asking for what's theirs. Get someone who knows the system to take care of it right the first time.

The information relayed in this blog is for educational purposes only and is not legal advice. The cases referenced and explained by the blog's author(s) are for informational purposes only and are not intended to imply that certain, or similar, results may be achieved in each client's case.

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