Medicare Advantage Plan Liens

Medicare Advantage Plan Liens

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

The MA Plan provides all of Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. MA Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Medicare pays a fixed amount for your care every month to the companies offering MA Plans. These companies must follow rules set by Medicare.

Medicare Advantage Glossary

Resolution

The process of notifying, verifying, and negotiating a lien until final resolution is reached. This may include the pursuit of compromises, appeals or waivers until the lien holder produces their final offer for recovery.

Verification

The process of determining if an insurer has a lien (an affirmative obligation to the lien holder). If there is a lien, the case is negotiated to resolution.

Medicare Conditional Payment FAQ

How much can the Medicare Advantage Plan Recover?

The MA Plan may recover the total amount of conditional payments made for injuries related to a Liability, Workers Compensation, and/or No Fault claim up until the date of settlement. Under current law the Medicare Advantage Plan  has the statutory right to request full reimbursement up to the full amount of the settlement if the total amount of related charges is equal to or greater than the settlement amount. If reimbursement is made as a result of a settlement, judgment or award, they should  reduce the lien amount based on a pro-rata share of the procurement costs (i.e. attorney’s fees and additional expenses).

What happens if I fail to repay my debt?

Failure to repay your debt within the specified time frame may result in additional recovery procedures. The Medicare Advantage Plan may also recoup this money from anyone else that has been given money from the settlement, including the beneficiary’s attorney.  Additionally, the Medicare Advantage Plan can double their recovery amount if they are not repaid.

TESTIMONIALS

"I just want to thank Synergy for their great work in getting a health insurance lien resolved. The health insurance company refused to reduce their lien a penny from a motorcycle accident involving my client who was not wearing a helmet, a fact that would have hurt our award in front of a jury. Synergy put tremendous pressure on this company, and after months of bombarding this insurance company with statutory requests and threats, they were able to get them to give in and reduce the lien significantly. The cost was minimal in relation to the hard work they put in, and the savings my client received. Client was very happy, and it allowed me to close out a case that I had resolved over 6 months before. Keep them in mind if you are dealing with a smug insurance adjuster who felt confident he would not have to reduce a lien, like I was dealing with. Thank you very much Synergy."

Jeffrey A. Adelman, Esq.
Adelman & Adelman, P.A.

"I was smart enough to hire Synergy Lien Resolution Services. Kudos to Synergy for tracking down ALL the medical bills, hounded Medicaid to pay them all, got all providers to state zero balances and then negotiated Medicaid down to accept $30K [down from 200k] to wipe out all of the medical bills."

Marianne Howanitz, Esq
Marianne Howanitz Law Offices

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