What You Need to Know About Medicare, Medicaid, and Personal Injury Settlements

Medicare and Medicaid Coverage

The terms Medicare and Medicaid are sometimes confused for one another, but they are two different medical insurance programs.

Medicaid is health insurance coverage for eligible low-income adults and children, and disabled individuals. It is sometimes also referred to as Medical Assistance or simply “MA.” Medicaid is usually managed at the state level.

Medicare covers adults 65 and older, some younger people with disabilities, and people with end-stage renal disease. Medicare is administered at the federal level.

Medicare and Medicaid Personal Injury Claims

If you have insurance through Medicare or Medicaid, they will typically pay medical bills that are the result of a personal injury claim, such as an automobile accident. You are required to tell your insurer that your injuries are due to an accident. You should also tell them if you are pursuing a settlement. 

If you have Medicare, you will need to contact your Medicare Coordination of Benefits (COB) Contractor. If you have Medicaid, you should start by contacting your insurance’s customer service number.

Medicare or Medicaid will likely ask for the name of any healthcare providers that you are seeking treatment from. If you have hired a personal injury lawyer, it’s a good idea to give your insurance their contact information.

Medicare, Medicaid, and Liens

You must notify your insurer about your personal injury because they may request to be reimbursed for any associated costs. In order to be reimbursed, they may place a lien on any settlement you receive. This means that if you win a settlement for your injuries, your insurer may have a right to be reimbursed from those funds.

Failing to notify Medicare or Medicaid about injuries resulting from an accident could jeopardize your future eligibility for coverage. Also, some injuries are automatically flagged as potential personal injury claims, such as broken bones. It is possible that if you do not report your injuries as the result of an accident, your insurer will contact you anyway.

A knowledgeable personal injury lawyer will help you navigate communication with Medicare or Medicaid. If you receive any paperwork or requests from your insurer, share them with your personal injury lawyer.

Disbursement of a Settlement

In most cases, if you are awarded a settlement Medicare or Medicaid must be paid for healthcare costs associated with your injuries. Typically, your lawyer will pay them directly after your settlement is awarded. You and your lawyer should go over your medical bills to make sure they are complete. You should make sure that any medical bills that are not related to your accident are excluded from the lien. 

Each lien situation is different, and laws can differ from state to state. Depending on your situation, your lawyer may be able to negotiate a lien with Medicaid. Laws regarding personal injury liens are complex and can change. It’s important that an experienced personal injury lawyer is handling your case. 

Finding the Right Personal Injury Lawyer

We know that dealing with a personal injury claim is overwhelming. You are recovering from your injuries and may be unable to participate in work, school, and other daily activities. The right personal injury lawyer will handle the legal aspects of your claim, allowing you to recover. 

The lawyers at Saladino & Schaaf have over 85 years of combined experience representing personal injury victims. If you believe you have suffered a loss due to personal injury, we encourage you to contact us as soon as possible. You may be entitled to compensation for your injuries. However, you must act quickly. There are time limits on legal actions.