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 have been very impressed by the results achieved by Synergy Lien Resolution Services. They saved my client over $108,000 in reducing a difficult ERISA lien. Their expertise was invaluable and resulted in a very happy client. Best money I ever spent. I wholeheartedly recommend them. You are doing your client a disservice if you don’t hire them to help you with your liens."

Armando Payas, Esq.
Payas Law

"We have been using the lien resolution services Synergy offers for over a year, and it has been a load off of our back. As a trial attorney, I need my staff to spend time on litigation, not waste their time on hold with Medicare. The time and effort that we used to spend resolving issues with Medicare is now being used in much more productive ways. I haven’t called Medicare in over a year, and I hope I don’t have to call them again."

John D. Ayers, Esq.
Marks & Harrison, P.C.

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