Can my health plan subrogate against me?

Question

I was in a solo automobile accident and taken to the hospital. My health insurance plan covered this. Now I've received a letter from a subrogation company stating they are going to pursue recovery of this cost. This doesn't quite make sense to me since they would be going after "me" on behalf of "me". Will I end up having to pay my plan back for my hospital bill?

Answer 1

Nearly any medical plan can subrogate to recoup a loss.

Usually the Auto Insurance pays primary to the Medical Insurance (although that it isn't always the case). If you were to have a rider on your Auto Insurance to make your Medical Insurance Primary then obviously, your Medical would be primary.

However, if your Auto Insurance should have paid primary, your Health Insurance plan can subrogate to make sure your Auto Insurance Carrier does pay for the claim.

Answer 2

Medical for a car accident should be covered by whatever medical coverage you have on your car insurance first, not your health insurance.

Answer 3

Possibly.

I sounds like you have an ERISA plan. That's an employer sponsored plan.  It will have a provision that says they can recover in event another insurance settles with you. Most of the time, that applies to liability payments from someone else's insurance.

If your bills were paid by medical payments -- it depends on teh laws of your state. I my state, the ERISA plan can go back after you for repayment from any liability payments you received. However, they can not go after the medical payments.

Your best bet is to call your Med Pay adjuser. He/She should be able to explain how the law works in your state.

Answer 4

Absolutely - they are actually subrogating under your AUTO POLICY, looking for coverage there.    In some states, health insurance policies don't COVER auto related injuries - you have to collect under auto med pay.  If that's the case for your state, they CAN recover from you, even if you don't have med pay (or not enough med pay).

In ANY case, you can't submit a claim to your health insurer AND your auto insurer, and get paid for both.  That's called "double dipping".

You need to call your auto agent, and ask about your injuries, and how your auto policy applies.

Answer 5

I have met similiar situation before.It is not easygoing,however,I get through it well eventually.here is the resource i find is useful for me.hope it works for you.http://health-insurance.expert-tip.info/...