If you have health insurance you should almost always use it when you are injured. Some people have argued that their health insurance shouldn’t have to pay because it was someone else’s fault. This is usually a bad way to think about your bills. What happens when you are injured in a car wreck, you don’t use your health insurance and the other person’s auto insurance doesn’t want to pay? The answer is that you start getting collection letters. Use your health insurance. This is why you have it. It also can greatly reduce the amount of medical bills you have to pay out of your settlement. For example, a hospital can typically charge anywhere from $5,000 - $25,000 at the emergency room just checking you out and running tests. If you have health insurance, that bill is cut way, way down. Hospitals have an agreement to accept a certain amount for certain services and these amounts are less than half of the bill you see.
Despite your requests and demands, many hospitals will still refuse to bill your health insurance even if you have Medicaid or Medicare. Did you know that there is a law in Texas that the medical provider has to use your health insurance? If the medical provider refuses to use your health insurance it is only allowed to collect what it would have received if they did the right thing and billed your health insurance. I have actually sued hospitals for not billing Medicare when they demanded to collect their full giant hospital bill. It’s the law and it should be followed. A hosptial shouldn’t get a windfall because someone else injured you.
Do I have to pay it back?
This depends on your health insurance. Medicare, Medicaid, the VA and any other State or Federal insurance plan must be repaid. They will often times take a reduction in their reimbursement total, but it has to be paid and it is not an option. Private health insurance plans are another matter. Most all plans include provisions that require them to be paid back if you are able to collect money from someone else that caused you to have the medical treatment. The law states that as soon as the attorney is aware that a reimbursement (often called subrogation) is owed then the attorney is required to make arrangements to pay back the health insurance. There are laws in Texas that require these health insurance plans to take certain reductions so that they aren’t taking all of your injury settlement. There are some plans that aren’t real insurance and these are treated differently. Failure to pay it back can result in losing your health insurance and you could even be sued for that money. Only an experienced attorney can help resolve these issues.
My goal as your attorney is to get the maximum recovery for your injury that I can. This includes using your health insurance to reduce the amount of your medical bills, paying back what I am required to pay back and giving you my best advice on all the rest.