Imagine that you have experienced a car accident injury through no fault of your own.  You need treatment for your injuries, but you don’t have private health insurance, and can’t afford the costs of health care.  Many people do not understand that they may be eligible for government-subsidized health insurance benefits that may be just what is needed in such a situation.

Social Security: How do I use this towards my expenses?

Using Medicaid and Medicare for Your Personal Injury Medical Expenses

Medicaid is often overlooked as an affordable health insurance option. Some think if they have a job, they won’t qualify for Medicaid.  Medicaid will pay health care expenses for low-income families and individuals. Each state sets the eligibility requirements. If you are working and still don’t have enough to buy affordable health insurance, it doesn’t cost you to see if you qualify for Medicaid, so it is always best to check Medicaid first before moving on to the next options.

elderly woman who uses social security benefits

If you are 65 years old or older you should qualify for Medicare. You may also qualify if you are getting Social Security disability benefits or if you have certain long-term health conditions.

Using The Affordable Care Act for Your Personal Injury Medical Expenses

The Affordable Care Act, passed in 2010, provides for expanded access to and better integration of care for many Americans who need it, through both the Medicare and Medicaid programs. In March 2012, CMS released two final rules defining the eligibility and enrollment policies needed to achieve a seamless system of coverage for individuals who will be eligible for Medicaid beginning in 2014.  It is still unclear how and whether benefits provided by the State of Louisiana (Medicaid) will be expanded, due to the state’s position that the benefit eligibility under Medicaid is not mandatory.

What About Medicare and Medicaid Liens with My Claim?

If you have Medicare or Medicaid and you use your benefits for treatment for your personal injury, it is important that you know that Medicare and Medicaid will have a subrogation interest on any first-party or third-party insurance recoveries.  That means that any amount that is paid to your health care providers for your treatment must be paid back when any claims against the at-fault party are settled. Failure to pay the money back could mean that you lose your eligibility for any future benefits  Even worse, it could mean personal liability against you, your attorney, and even the insurance company who settled the case.

Medicare does have some authority to reduce or waive Medicare liens under certain circumstances, and claimants and attorneys must be sure that those circumstances apply and that all procedural requirements are met in order to receive a reduction or waiver.  It is important to note that dealing with Medicare requires a lot of patience, because getting a response from Medicare takes time and will involve multiple phone calls and letters. Virtually every time Medicare is contacted, someone will tell you that they need another 45-90 days to respond to a request.  Resolving a Medicare lien often takes up to six months or even a year.  On the other hand, a Medicaid final lien amount can be obtained much more quickly then a Medicare lien.

Aside from New Orleans, our Louisiana personal injury attorneys are also located in Shreveport, Baton Rouge, Alexandria, Lake Charles, Monroe, and Lafayette; in Hattiesburg, Pascagoula, and Gulfport in Mississippi; in Mobile, Birmingham, Huntsville, and Montgomery in Alabama and in Texarkana, Arkansas. If you have questions about your Social Security benefits, contact us today!

April 18, 2013 | Categories: Legal Tips | Tags: , , ,