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

"Synergy Lien Resolution Services was extremely knowledgeable and effective in assisting to reduce our client's insurance lien. They were a pleasure to work with, extremely professional, and went above and beyond the scope of our expectations. Many times, throughout our case, they worked after business hours to accommodate our needs. The end result was a huge savings for our client and we hope to utilize the Synergy again in the near future."

Joni Hautamaki
Didier Law Firm

"I learned of Synergy through the state trial lawyers association when I was looking for help in dealing with Medicare. As you know, dealing with Medicare can be difficult and time consuming. We all get the articles and updates regarding Medicare, but Synergy does an incredible job of clarifying so many questions. I cannot thank you and the Synergy staff enough for the assistance, insight, and professionalism. You can be sure that I will only be recommending Synergy to my clients for Medicare issues in the years to come."

Jared P. Greenberg
Greenberg & Strelitz, P.A.

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