March 14, 2020

You did the smart thing after your Tampa accident and used your health insurance to get the care you needed. Then you hear a word that makes your stomach drop: lien. Suddenly it sounds like everyone who paid a medical bill wants a piece of your settlement. Here’s what a medical lien really is, who can claim one in Florida, and why the right approach often leaves more money in your pocket, not less. TL;DR — QUICK SUMMARY A medical lien is a legal claim to be repaid from your settlement by whoever covered your accident-related medical care. Your health insurer can seek repayment through subrogation, but under Florida Statute 768.76 its lien is reduced by its share of your attorney’s fees and costs. Medicare and Medicaid have far stronger repayment rights that cannot be ignored, with Medicaid’s lien attaching automatically under Florida Statute 409.910. Using health insurance usually shrinks the bill, because insurers pay providers at reduced negotiated rates, so less comes out of your recovery. Most liens are negotiable, and resolving them before you sign is how you protect what you actually take home. The Reyes Firm Worried a Lien Will Eat Your Settlement? Let us protect what you take home from your Tampa claim. Had a bad day? Contact Us Now $10,000 Florida PIP pays before health insurance Fla. Stat. 627.736 Pro Rata Health insurer liens cut by their share of fees Fla. Stat. 768.76(4) Automatic Medicaid’s lien attaches by law Fla. Stat. 409.910(6) 2 Years To file an injury lawsuit Fla. Stat. 95.11(3)(a) What is a medical lien, and why does it come out of your settlement? A medical lien is a legal claim to be repaid from your settlement by an insurer, provider, or government program that covered your accident-related medical care. The idea behind it is simple: those bills were paid on the understanding that, if someone else caused your injuries, the money would be paid back out of whatever you recover from the at-fault party. This matters most when your injuries are serious and your bills are large, such as after a catastrophic crash. A lien does not reduce what the at-fault party owes you. It determines how much of your recovery you actually keep after the people who paid your bills are reimbursed, which is why understanding and controlling these liens is a real part of winning your case. Who can put a lien on your personal injury settlement in Florida? Several different parties can claim repayment, and they do not all have the same rights. The most common lien holders are your private health insurer, which may seek reimbursement through subrogation; hospitals, which in some Florida counties, including parts of the Tampa and Hillsborough County area, can assert a lien under a local ordinance; and government programs like Medicare and Medicaid, which have powerful repayment rights set by statute. There is also a fourth situation. If you had no health insurance, or chose not to use it, a doctor may have treated you under a Letter of Protection, which is an agreement to wait and be paid directly from your settlement. That arrangement creates a lien-like claim on your recovery too. The first job in any case is identifying every one of these claims, because a lien you forget about does not disappear, it follows you. How does health insurance subrogation actually work? When your health insurer pays accident-related bills, it often has a right to be paid back out of your settlement, and that right is called subrogation. Under Florida Statute § 768.76, a health insurer that has properly asserted this right can be reimbursed only from what you actually recover, and its claim is reduced by its pro-rata share of the attorney’s fees and costs you paid to obtain that recovery. Two things make this far better for you than it first sounds. The insurer is usually repaid based on the discounted rate it actually paid the provider, not the much higher billed amount, and that repayment is then cut down by its share of your legal costs. The main exception is a self-funded employer health plan governed by federal ERISA law, which can have stronger reimbursement rights than a state-regulated plan, so the type of plan you have genuinely matters to the outcome. 💡 Did You Know? Under Fla. Stat. § 768.76, a health insurer’s reimbursement is limited to what you actually recovered and must be reduced by the insurer’s pro-rata share of your attorney’s fees and costs. Combined with the discounted rates insurers pay providers, this often means using your health insurance leaves you with more money than letting the full medical bill ride to settlement. Source: Fla. Stat. § 768.76, leg.state.fl.us. What about Medicare and Medicaid liens? Government liens are a different animal, and they cannot be ignored. Florida Medicaid is automatically subrogated to your claim and holds an automatic lien for the full amount it paid under Florida Statute § 409.910, while Medicare’s repayment rights come from federal law and function as a so-called super lien on your recovery. The good news is that the amount these programs actually collect can often be reduced, for Medicaid by reasonably allocating your settlement to past medical expenses, and for Medicare through its conditional-payment resolution process. The bad news is that disbursing your settlement without addressing them is a serious mistake, because the government can pursue repayment afterward, with interest. These claims come up in any case with major medical care, including large truck and commercial vehicle settlements. ⚠️ Deadline Warning: Under Florida Statute § 95.11(3)(a), you have two years from the date of your crash to file a personal injury lawsuit. Missing this deadline almost always means losing your right to recover anything. Don’t wait to call a lawyer. Watch: How medical liens affect your settlement In this short video, attorney Edward Reyes explains how medical liens work and why using your health insurance can still be the smart move after an accident. Tampa personal injury