Currently on Medicaid/Medicare permanently disabled, receiving settlement for personal injury. Can I still receive Medicaid?


Permanently disabled for 7 yrs, recently further disabled due to stroke from personal injury 2yrs ago. Currently receiving social security disability, Medicaid and medicare to sustain health care. Possibly receiving a settlement of 100k or more after fees for personal injury that caused additional disability. How will this affect my Medicaid and Medicare services? Will they discontinue my health coverage? Is there a way to protect my money for living expenses and care expenses without terminating my health coverage?

This question has been closed for answers. Ask a New Question.


You may have issues for both Medicare & Medicaid.
For Medicare, you may have to deal with is Medicare Secondary Payer Act (MSP), which is about Medicare being reimbursed for any payments they made for medical expenses for a Medicare covered individual in which another individual, business or other entity was later found responsible for and made a financial settlement to the Medicare covered individual. Your 100K would be the settlement for you. The regulations came out in 2013. It's going to be a nightmare for self-insured's to comply with. If you had an attorney, you need to contact them.

What the medical charges total, what Medicare paid for and what the settlement paid is critical to determine how much everyone gets, this is why you need to see the attorney who handled the claim or lawsuit. It may be that the attorney will need to set up an account that the $100K in the settlement goes to; and from that due to Medicare comes from and is not released to you until Medicare sends attorney a letter that the reimbursement is settled in full and then the balance released. If an attorney wasn’t involved (like if was a product liability claim & you filled out a form), then you would need to contact MSP compliance dept of the insurance company who is paying the settlement. They may send you a questionnaire before the check is issued in which you have to state if any insurance company or other entity is due reimbursement from your settlement too. All this is tied to your SS # so the 100K will surface eventually so both Medicare & Medicaid will find out. If there are any funds left after the MSP recovery, if it takes you over the $ allowed by Medicaid, it will stop.

Medicare Secondary Payer reimbursement only applies to funds you receive, the attorney does not with withheld any of their payment or % for representation.
Helpful Answer (0)

Your SSDI and Medicare will continue, but the Medicaid will NOT. Medicaid is for low income and $100K will put you over the limit. Talk to your caseworker, because when you get the money, you have to report it and stop the Medicaid Benefits. You would then have the option of a Medicare supplement coverage, which is not too expensive. It may not be as bad as you think and the settlement should carry you for several years.
Helpful Answer (0)

This question has been closed for answers. Ask a New Question.