If TRICARE covered your injury-related bills and you later receive compensation for those same bills from a personal injury settlement, you are obligated to pay back TRICARE for the costs it covered.
Millions of servicemembers and military families depend on TRICARE for health insurance. This government-run insurance program can cover all types of medical expenses, including those incurred in a crash.
It is common for crash victims to use whatever health insurance policy they currently have to cover their wreck-related medical bills while they wait for the at-fault party’s auto insurance to give them compensation for their injuries. Let’s look at why any policyholder, including those covered by TRICARE, might need to pay their health insurance provider back after receiving a settlement from the auto insurance company.
Understanding ‘Medical Liens’ After a Crash
Health insurance providers often cover injury costs after a crash with the understanding that, if the injured person eventually gets compensation in a personal injury claim, the provider will be paid back for the costs it covered.
This concept is called medical reimbursement, and it is a common practice among health insurers. Just like other insurance providers, TRICARE will expect to recover payment for any injury-related costs that you receive via a personal injury settlement. To enforce recovery, health insurance providers like TRICARE, Medicare, and others can file a “lien” to protect their claim.
How Do I Coordinate Payment with TRICARE?
If you hired an attorney to handle your claim, then they will likely handle this for you. Your lawyer will deduct what TRICARE is owed from your settlement and mail them payment. If you have handled your own personal injury claim, then you should reach out to TRICARE to coordinate reimbursement.
Working effectively with TRICARE requires knowing how this system operates, as it is not exactly like other insurance providers. For example, your attorney is legally required to pay back the TRICARE lien from a settlement before taking out their own fees. Though many attorneys know this, it is also possible that your attorney doesn’t fully understand TRICARE’s requirements regarding a medical lien if they do not have experience working with military families.
If you receive correspondence from TRICARE saying that you owe them money, contact your lawyer to ensure the process was handled correctly. If you are a servicemember or a member of a military family, find a law firm that fully understands the privileges you are eligible for and all the ways your lawsuit may be affected.
Do I Need to Pay the Full Amount of Covered Expenses Back to TRICARE?
TRICARE is within its rights to demand full repayment for the costs it covered that you received compensation for. However, experienced lawyers who thoroughly understand these types of cases know procedures to request and receive reductions and, in some cases, even waivers. This allows you to keep more of the money you receive in any settlement or jury verdict.
Every case is unique, and the process takes time, but injury victims can often keep more of their compensation when the correct protocol is followed and the process is managed effectively.
Speak to an Experienced Lawyer at The Law Offices of Gary Bruce
Based in Columbus, GA, the Law Offices of Gary Bruce has represented many servicemembers and military families stationed in Fort Benning and around the world. We have years of experience working on claims that involve TRICARE, and we understand the complexities of dealing with this healthcare program.
If you would like to speak with an experienced law firm at no cost, contact our team today for a free, no-obligation case assessment.