Help! The lien my Medicare Part C plan is seeking is bigger than my entire settlement.

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Question: I settled a disputed liability personal injury case for $100,000. A [retracted] Medicare Part C plan is now claiming a $130,000 lien – is this lien enforceable?

 

Answer: With regard to your question, I can confirm that the specific policy you mentioned is in fact a Medicare Advantage plan (Part C). This plan has strong subrogation/reimbursement language in its Evidence of Coverage (written policy provided to Part C enrollees). Whether relying upon this language or a statutory claim rooted in the Medicare Secondary Payer laws, the plan will contend that it has a valid claim to reimbursement. Under the circumstances of this case I would suggest asking for an equitable split of the available settlement proceeds (1/3 split of the 100k).

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