Can I Use My Health Insurance To GET FREE MEDICAL CARE After An Injury? Should I?

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March 20  

“Can I use my health insurance for my injury treatment?” 

In this article, we will answer the question if you can use your healthcare insurance for your injury or what if you don't want your doctors to use your car insurance or your health insurance to pay the medical bills.

In other words, can we control who pays the medical bills or whether a doctor submits bills to health insurance? The reason I’m bringing this topic is because the client called me to ask that she doesn't want to be personally liable for any bills. And that's smart because the way it works is you know if you if your medical bills get paid up front by your health insurance, the only thing you might ever be on the hook for might be like a co-pay or a deductible that you got to pay anyway. So, there's nothing wrong with that, but you know this client also thought that if her health insurance paid her medical, that would be it any money she got from her injury case would just go straight in her pocket. That doesn't actually work that way.

Insurance Pays Your Medical Bills

The way it works is, if your health insurance pays your medical bills related to an accident, they can request to be paid back a percentage of what they paid for the medical care you got related to the crash. A lot of people don't know that, and they think it's not fair but it's in that tiny print in your health insurance booklet that they send you once you have private health insurance.

Now, do they always come after it? No. But if they get in any indication that there's an injury case or anything like that, or if you call them and they contact you once they are aware of it or make any communication whatsoever indicating that they want to get paid back. Another is if they want information about the accident, then you're contractually obligated to pay them back, so just because your health insurance pays accident medical care does not mean you're off the hook.

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You Need To Pay Them 

You may have to pay them at the end of the case, the flip side is, my doctors that I’m going to for my injury asked for my health insurance and I don't want my health insurance to pay. I want the other driver's insurance, or I want my employer to pay for my medical care related to the accident and that's understandable too, that's usually motivated by a sense of like justice the person who hurt you or who's legally responsible to pay your bills ought to pay your bills. Again that's very understandable, but doctors have the choice.

If a doctor gets your health insurance info and he's blue cross blue shield covered, he can choose whether to submit the bills through blue cross blue shield or try to get paid through your injury case. So if it's workers comp, usually workers comp pays comparable or better rates for the care so that's an economic extent of why a doctor's office might want to get paid through that instead of health insurance.

Another thing to think about is, if it's like a car accident, the doctor's bill might get paid very close to 100% depending on how serious the injuries are and a host of other factors. At the end of the case, I sit down with all the numbers, and I have to do a bunch of math, I actually created a little program to shortcut it for me, but the bottom line is it can take a long time.

It's complicated, it requires a lot of negotiations with the doctors, so my point is whether you want all your bills to be paid through the doctor or through your health insurance or you don't want your health insurance to pay, we don't have complete control over. The doctor can always choose to get paid through the case or if they decide to run it through Aetna or United Healthcare or Blue Cross Blue Shield, whoever you've got, you know they can do that and you're still going to be in the short term on the hook for deductibles.

At the end of the case, we've got to pay them some money back, so that's how that works. So, I hope that answers your question and if you or a loved one needs a lawyer, please give me a call, you can reach me 24/7 at 312-500-4500.

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About the author - Scott D. DeSalvo

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