You have an obligation to satisfy the lien by paying it out of your settlement. Insurance companies often seek reimbursement for medical costs directly from the settlement, a process called subrogated interest.
The amount taken out of the settlement is dependent upon the nature of the costs fronted by an insurance company or healthcare provider and the nature of the lien. Many liens are negotiable, and even disputable. Hospitals often agree to accept less than the full lien amount, waiving the balance owed.
In the state of Indiana, liens cannot be filed against someone who is receiving Medicare or Medicaid benefits.