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Do I have to pay back Medicaid from insurance settlement if Medicaid did not pay bills but other party insurance did ?

Watertown, CT |

I'm receiving a settlement from an auto accident . I'm on Medicaid but Medicaid did not pay the bills , the other parties insurance did . Medicaid paid past bills for me not related to the accident , ( IE : sickness ) . Will Medicaid be entitled to be paid back from my settlement for past bills paid on my behalf not related to the accident in Connecticut ?

Attorney Answers 7


  1. Have you talked to your personal injury attorney about this situation? If not, that is the only place for you to start. If you do not have an attorney, you truly need to sit down with someone locally to make sure that you are meeting all obligations attached to receipt of your settlement dollars. I practice law in Colorado and here, if you receive a personal injury settlement, not only may you need to reimburse Medicaid for bills paid (I undertand you tell us they did not pay here), but your eligibility for Medicaid could be affected -- and in the future, Medicaid could tell you they are not paying for future care until you exhaust the dollars you've received.

    I can't imagine sending anyone in to settle a case with Medicaid involved without seeking counsel from an experienced personal injury attorney.

    Best of luck to you.

    Dan

    In no way am I offering you legal advice, and in no way has my comment created an attorney-client relationship. You are not to rely upon my note above in any way, but insted need to sit down with counsel and share all relevant facts before receiving fully-informed legal advice. If you want to be completely sure of your rights, you must sit down with an experienced criminal defense attorney to be fully aware of your rights.


  2. I agree with counsel that you should not settle without the advice of an attorney, you can definitely create a situation where you need to have a "spend down" of your own funds until you are once again eligible for government benefits.

    Depending on facts, state, etc., you may have the right to create a "SPECIAL NEEDS TRUST" where the money from the settlement is never paid by check to you but directly into a special needs fund where you can take funds out under certain rules and restrictions.

    I recommend you get Medicaid eligibility advice from an attorney in person you can find one on AVVO.

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  3. They are not entitled to reimbursement for non-related treatment from your settlement but your settlement ay affect your future eligibility so I would consult an attorney to advise you how to proceed.

    Call for a free consultation at 727-937-1400 or visit us on the Web at www.serviceandjustice.com.


  4. Medicaid will want at least a portion of non-accident related money from your settlement if they can get it. The State typically asserts a lien against personal injury cases for anything they've paid in the past, whether other medical bills, welfare payments, child support, whatever. Usually attys fees and costs come off first, then accident-related medical bills if any need to be paid out of the settlement, and then the State will want to split with you whatever is left after that. There are good lawyers in the Waterbury area, talk to someone near you.


  5. All the attorneys are correct. You may need to pay Medicare

    Attorney Bonanno's answers to questions are for general purposes only and do not establish an attorney-client relationship. You should carefully consider advice from an attorney hired and who has all facts necessary to properly advise a client, which is why these answers to questions are for general purposes only and do not establish an attorney-client relationship.


  6. This is an issue we are very often faced with in CT. Medicaid is not entitled to be paid back non-accident related medical expenses. However, DAS (Department of Administrative Services) may place a lien on your file if you had received any type of state assistance in the past, regardless of how long ago. I have had liens placed on a client's settlement by the State for assistance the client received over 20 years ago. You should definitely consult with an attorney (If you have not already done so) so as to determine what amount, if any, you owe the State.


  7. Yes, but don't sign the release for your settlement until your attorney negotiates this lien down to 5-10 cents on the dollar. Make him earn his windfall.

    Only 29% Contingency Fee! Phone: 215-510-6755 www.InjuryLawyerPhiladelphia.com