Tuesday, December 5, 2023

Personal Injury Settlement And Medicaid Eligibility

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Common Medicaid Preservation Techniques For Florida Personal Injury Clients

Medicaid and Personal Injury Settlements

1. Spend Down: Medicaid recipients can spend their money . This typically makes the most sense for small personal injury settlements. They are free to buy clothing, pay off credit card debts or other loans, buying a big-screen TV, going out to a nice dinner, travel expenses, making repairs to the home or car, and more. As long as they can spend the amount in the same calendar month in which it is received, they can report same to DCF/SSA and retain their Medicaid benefits.

3. Personal Services Contract: The personal services contract is explained in more detail here: . But, essentially, a Medicaid recipient can transfer money to a caregiver after this services contract is properly signed. If done properly, Medicaid will not deem the transfer of assets to be a gift, but rather a payment for the fair market value of services to be received. The primary drawbacks to personal service contracts are: loss of control of the money . In addition, there is likely an income-tax consequence to the caregiver . We don’t give tax advice, so this is an issue they will need to discuss with an accountant or tax adviser.

4. Annuities: There are Medicaid compliant annuities that can convert a personal injury settlement into an income stream. The income will be counted against Medicaid eligibility, but the asset will not. This is a particularly useful medicaid-preservation tool when the Florida-Medicaid recipient is married to a non-Medicaid recipient.

What Is The Government Benefit Assessment For

In fact, our firm received such a high volume of inquiries about this topic from attorneys and settlement recipients across the country that we developed an online screening process that we allow firms to use at no or very little cost. We call it the Government Benefit Assessment.

The Assessment screens your clients for the types of government benefits they are receiving and then triages which benefits they are receiving. With that information, we then educate you and your clients on whether a settlement will impact the government benefits your clients are receiving.

In other words, our screening process can help you determine if a client needs further planning through a special needs trust , or if you can go ahead and send your client their settlement funds without having to worry about your client losing their Medicaid eligibility .

Exempt Assets For Medicaid

In general, most assets are not exempt from Medicaid eligibility calculations. There are a few exemptions for things that are considered core items that individuals or couples could not reasonably be expected to live without. This could include:

  • A primary residence worth up to $500,000
  • An automobile
  • Various types of life insurance
  • Wedding and engagement rings

However, personal injury settlements are counted as assets when it comes to determining Medicaid eligibility.

Recommended Reading: Personal Injury Lawyer Lynchburg Va

How Does Medicaid Affect The Value Of A Settlement

In Missouri and Kansas, if a person has been injured due to another persons negligence, insurance companies will often find any basis they can to deny claims or to pay as little as possible on claims, thereby forcing people to file suit. Many people dont realize that suit is actually filed against the at-fault person and not against the insurance company . Thus, if another driver negligently hurts you, your lawsuit would be against that driver, not the drivers insurance company. However, the other drivers insurance company hires the defense attorney and pays the defense attorney, and it will ultimately pay any jury verdict, up to the policy limit.

Unfortunately, juries in Kansas and Missouri are never allowed to be told that a defendant has insurance, even though in the major majority of cases, the defendant either has insurance or substantial assets to satisfy any judgment against the defendant. Both the insurance industry and the Chamber of Commerce have funded and helped ensure that juries do not ever get to know that insurance exists.

As the law stands right now, juries are able to see both amounts, but they are given very little instruction on what to do with those amounts.

Is Repayment Of A Past Medical Lien Required

Medicaid and Personal Injury Settlements Ohio

Anytime Medicare or Medicaid has paid for medical benefits, there is an obligation on the part of both the client and the attorney to repay the lien if money is recovered from a negligent third party for damages suffered out of the incident that produced the medical bills. It is important to note that the statute does not differentiate what the settlement money was paid for. The lien is on the entire settlement. Failure to repay a Medicare Lien carries with it the ability of the Federal Government to sue the lawyer for double damages plus interest for knowingly ignoring a Medicare lien. State Medicaid lien laws vary from state to state, but you can rest assured that at a minimum, the state can sue the client and the lawyer for the amount of the lien with interest. Medicare requires that you fill out a form and notify them of every personal injury case so that they can check to see if they have a claim for medical bills paid, Thus, a prudent personal injury lawyer handling a personal injury claim must take steps to confirm and take into account any Medicare and/or Medicaid liens.

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Can A Personal Injury Settlement Affect Medicaid In Ohio

The long and short answer to can a personal injury settlement affect Medicaid in Ohio is yes.

Medicaid can affect a personal injury settlement via the fact that they will seek reimbursement for any kind of medical costs that they covered for your care after an accident.

If you have questions specific to your case and what Medicaid might seek, reach out to a personal injury lawyer in Columbus, OH.

Florida Medicaid Asset Test

The asset test just says that a Medicaid recipient cannot have more than $2,000.00 in combined countable assets . There are a few items that are usually not countable by Medicaid: the most typical of the excluded / non-countable assets are: the value of the homestead and one car. There are other assets that are excluded but I wanted to keep this article brief.

What is considered a countable asset? Nearly everything elseâ especially all funds that touch their bank account, brokerage account, etc⦠So, even though the IRS doesnât count a personal injury settlement for tax purposes, Medicaid most certainly does when they are evaluating eligibility.

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Spending Down Medicaid Assistance

To continue to receive Medicaid one approach is to spend down the assets. Medicaid permits recipients to spend down through

  • Covering funeral expenses
  • Settling any debts
  • Purchasing items for your personal needs like clothing
  • Caregiving agreements

However, spending down may not always be the best approach. There are other options available if your father wants to hold on to more of his money. These include

Keeping Medicaid After Personal Injury Settlement Or Receiving An Inheritance

Do I Have To Pay Back Medicaid For Medical Expenses From My Personal Injury Settlement?

Partner at Elder Needs Law, PLLC

If a Medicaid recipient’s assets ever exceed $2,000 at the end of any calendar month, they will no longer be Medicaid-eligible . So, when someone receives a lump sum inheritance from a recently-deceased family member, or as part of a personal injury or medical malpractice settlement, the lump sum of money can be most unwelcome. This article will explain what happens when a Medicaid recipient receives a sudden influx of money and what they can do to preserve their Medicaid benefits.

Quickly, its important to note that the medicaid recipient may want to leave the program. If a Medicaid recipient inherits millions, or their personal injury lawyer obtains a huge verdict or injury settlement, he/she may now be able to well-afford private paying for their health insurance or long-term care needs. But if maintaining Medicaid eligibility is the goal, read on.

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Will I Lose Government Benefits If I Receive A Personal Injury Settlement

How to Avoid Losing Government Benefits when Receiving a Personal Injury Settlement

Government benefits provide much-needed assistance to low-income and/or disabled individuals and their families. Unfortunately, eligibility for certain government benefits may be jeopardized when the individual receiving such benefits is involved in an accident and is set to be awarded a sizeable personal injury settlement.

Fortunately, tools exist to protect an individuals eligibility for government benefits when they are set to receive a personal injury settlement that would increase their available resources above the resource limit . For example, an Achieving a Better Life Experience account or a Special Needs Trust may help shield personal injury settlements from being considered a countable resource for Medicaid and SSI purposes. However, sometimes an ABLE account or an SNT does not fit an individuals situation if that is the case, then there is another option to be considered the Spend Down Method.

ABLE account:

An ABLE account is a tax-advantaged savings account for the benefit of a disabled individual, with the onset of a disability prior to age 26.

An ABLE account may be used to fund qualified disability expenses, which include, but are not limited to:

  • Basic living expenses
  • Oversight and monitoring
  • Funeral and burial expenses

Special Needs Trust:

Overall, an SNT can be tailored to a specific situation, but the distributions are restrictive and administration is complex.

How Do I Receive A Personal Injury Settlement

If you were injured due to another person’s negligence, you may be entitled to compensation from a personal injury case. If you have been injured, you will need to show that the other person owed you a duty of care that a reasonable person in similar circumstances would have been required to show. Then you would need to show that you did sustain an injury, and it was the other person’s negligence that caused your injury. But what if you are also trying to qualify for Medicaid? Any personal injury settlements you may receive could possibly impact your Medicaid benefits.

Recommended Reading: Personal Injury Lawyers In Denver

How To Stay Eligible For Medi

After a personal injury settlement, the last thing you want is to lose your Medicaid or Medi-Cal benefits. But depending on the amount of compensation you get in your personal injury settlement, you may exceed the income limits that make you eligible for these programs.

Its important to consider that injuries can have long-lasting effects which take years or even decades to treat. Even if you settle for hundreds of thousands or millions of dollars, remaining on Medi-Cal can help ensure that your treatments remain covered.

You have a couple of options when it comes to remaining Medi-Cal eligible after your settlement: Spending down your settlement proceeds or creating a special needs trust.

A special needs trust can hold money without those resources counting towards your income. As a result, the money in the trust wont exceed Medi-Cal income limits. You can continue using money from the trust to pay for any medical expenses beyond what your Medi-Cal coverage pays.

Michigan Law Firms For Car Accident Settlements And Ssi Benefits


If you were receiving SSI benefits and had just gotten into a personal car accident settlement, know that there are legal ways to protect your eligibility. A dependable lawyer can bring you in the right direction. Choose the experienced attorneys at The Clark Law Office!

Our team of lawyers has years of experience in handling personal injury cases, including settlements and benefits. We are trained to look at every detail of your income and resources to ensure that you will still be able to receive the benefits that you deserve.

Medicaid Covers Now And Seeks Reimbursement Later

First, know that Ohio Medicaid will cover emergency and follow-up care for injuries suffered in a car crash, truck accident, slip and fall, dog attack, or other accident that would give you grounds for filing a personal injury claim. You do not need to worry about paying all the medical expenses forced upon you by someone elses negligence or reckless behavior.

It is also true that Medicaid will demand reimbursement from any settlement or jury award you receive. The program will only take an amount equal to what it spent in covering your care, though. In most cases, you will hold onto some or all of the compensation you received for lost wages, loss of future earnings, pain and suffering, and, when they exist, punitive damages.

Can The State Take My Fathers Nursing Home Abuse Settlement

The cost of long term nursing home care is out of reach for many. Therefore, its common for elders who need ongoing residential care to use Arizona State health insurance to help cover the cost.

While this funding method may seem quite simple, this can change if the resident receives an abuse settlement following a case of abuse or neglect.

You may be wondering if Arizona State health insurance can ask for a repayment should a family member receive a settlement. Or if theres a limit to the amount your health insurance provider can ask for. This article seeks to clarify these answers for you.

The injury attorneys at Phoenix Accident and Injury Law Firm near you have significant experience in helping clients who have been a nursing home abuse victim and need help getting their abuse settlement. Our offices are conveniently located in nearby Chandler, Peoria, and North Phoenix, and we can meet in-person at our nearby offices, or video call. You can contact us for a free consultation, or read on to find out more.

To figure out how the nursing home you have chosen for your family is rated and to see if the home has any prior violations, check out our nursing home index. Weve compiled all of the nursing homes in Arizona as well as their health code reports.

Additionally, take a look at our Nursing Home Glossary an index of important words you need to know in a nursing home abuse case and their definitions.

What Is A Special Needs Trust

Individuals using a Special Needs Trust must meet certain criteria including:

  • Establish your disability
  • Show that the Special Needs Trust will provide benefits for the individual

A Special Needs Trust can be established by:

  • Your individual’s parent
  • The disabled individual’s legal guardian or
  • A court.

In order to qualify for the Medicaid Special Needs Trust exemption, the trust must contain specific language that if you pass away, the state will receive the remaining amounts in the trust up to the amount equal to the amount of medical assistance paid.

If I Receive A Lump Sum Payment Like A Court Settlement Workers Compensation Payment Or Inheritance Will It Affect My Medicaid Coverage

Can I Keep Medicaid after Inheritance or Injury Settlement

How a lump sum payment affects your Medicaid eligibility and coverage depends on your Medicaid eligibility category. There are two Medicaid eligibility categories: Modified Adjusted Gross Income and non-MAGI.

MAGI Medicaid

MAGI Medicaid is available to adults ages 19 to 64 who do not have Medicare, children under the age of 19, pregnant women, parents and caretaker relatives , and certified disabled individuals who do not have Medicare.

In order to qualify for MAGI Medicaid, your monthly household income must be less than the monthly income limits set by the State. But MAGI Medicaid does not have resource or asset limits. This means cash savings, bank accounts, property, and other assets you own are not taken into account when determining whether you are eligible for MAGI Medicaid.

Under MAGI Medicaid, lump sum payments count as income in the month received if the federal income tax rules would treat the payment as income. You will need to know the source of the lump sum to determine whether the payment is counted as income. For example, under federal income tax rules, lottery winnings are counted as income but inheritances are not.

Because there are no resource or asset limits in MAGI Medicaid, you can save the money into the following months and your Medicaid coverage will not be affected unless the interest you receive from the payment will push your monthly income over the Medicaid limit.

Will You Lose Medicaid If You Get A Personal Injury Settlement In Pennsylvania

If you sustained an injury due to the negligence of another party, you are entitled to compensation. Unfortunately, there have been cases in which a settlement has resulted in the loss of public benefits, like Medicaid. This result is especially difficult for those whose injuries have resulted in additional and long-term medical bills. The Reiff Law Firm Pennsylvania personal injury attorneys explain how personal injury settlements may impact Medicaid eligibility and options for protecting your benefits.

Denton/dallas/fort Worth Dog/animal Bite Injury Attorneys

Many of us are dog owners, and we love our dogs just like a family member. In fact, for 2017-2018, The Humane Society of the United States estimates that 84.6 million households in the United Stated have a pet, and in 2015-2016, 42% of those households have more than one pet. In fact, in 2017-2018, 60.2 million households in the United States own at least one dog, which is 48.5% of all households. It is further estimated that in 2017-2018, there were 89.7 million dogs kept as pets in U.S. households.

Although dogs are a great source of companionship, joy, and laughter, they are animals and sometimes they attack and/or bite causing severe personal injuries. Bites and attacks from dogs and other animals can cause you and/or your child to suffer from serious physical and mental injuries. According to the American Veterinary Medical Association, dog bites pose a serious health risk to our communities and society. More than 4.5 million people are bitten by dogs each year in the United States, and more than 800,000 receive medical attention for dog bites, according to the U.S. Centers for Disease Control . At least half of those bitten are children. Here are more dog bite facts:

  • Almost 1 in 5 people bitten by dogs require medical attention.
  • Children are the most common victims of dog bites and are far more likely to be severely injured.
  • Most dog bites affecting young children occur during everyday activities and while interacting with familiar dogs.

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