Mississippi Health Plan Reimbursement: The Made-Whole Rule

By the FigureMyTax Editorial Team · How we calculate

We did not find a Mississippi statute that governs a health plan's reimbursement from your settlement. A compendium of subrogation law reports that Mississippi courts apply the made-whole rule and that contract language cannot override it, so a plan may be repaid only after you are fully compensated.

What the made-whole rule is

The made-whole doctrine says an insurer that paid your bills cannot be repaid from your recovery until you have been fully compensated for your losses. Some states enact it by statute; others leave it to courts. We found no Mississippi statute for a health plan.

What a compendium reports

A law-firm compilation of Mississippi subrogation law reports that subrogation of medical benefits is allowed, that in Hare v. State (1999) the Mississippi Supreme Court adopted the made-whole rule and held it is not overridden by contract language, that later Supreme Court decisions follow it, and that Mississippi does not distinguish equitable from contractual subrogation. We did not read the decisions, so treat these as leads.

A worked example

Say a health plan paid $9,000 and you settle for $100,000 with a one-third fee and $3,000 in costs. If your damages are $300,000 and you recover $100,000, you are not made whole, so a plan subject to the rule may recover nothing. If you are fully compensated, it may claim its payment, and we found no Mississippi authority on whether it must share your fees. The Mississippi medical lien calculator offers those positions.

Medicaid is different

Medicaid has its own statutory order of payment that does not depend on whether you are made whole; see the Medicare and Medicaid post and Miss. Code 43-13-125.

What to do

Ask for an itemized claim and the plan document, ask whether the plan is insured or self-funded, and ask it to confirm in writing that you have been made whole. A self-funded employer plan is governed by federal law. See how provider bills differ.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Mississippi's rules apply to your specific case with a licensed Mississippi attorney.