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Personal injury and medicaid and medicare

Houston, TX |

if i have medicare and medicaid should i file those now. i know it can reduce the personal injury claim. any more advice

Attorney Answers 3


  1. I'm not sure from your brief posting exactly what you are asking, so perhaps you shoud post more facts and ask a specific question. However, if you have medicaid or medicare and if you have had a personal injury, then if medical bills are paid by those sources, they have a statutory, automatic, lien which you and your attorney must determine, negotiate (to the extent possible) and pay prior to final settlement of the case. Not that big of a deal, but it does need to be done.

    This answer is provided for informational purposes only. Actual legal advice can only be provided in an office consultation by an attorney licensed in your jurisdiction, with experience in the area of law in which your concern lies.


  2. In any automobile accident case you should always look to available auto insurance first and before you submit any bills to Medicare or Medicaid for the reason mentioned by the previous attorney. Typically auto insurance is "primary" coverage and must be exhausted before secondary sources will pay benefits. Also and more significantly Medicare/Medicaid and private health insurers have a contractual or statutory "subrogation lien" which must be paid back to the insurer/payor like Medicare/Medicaid, while the auto insurance is often not subject to subrogation- i.e.-reimbursement.Thats a much better deal for you. Therefore you are correct that by reimbursing Medicare or Medicaid for thier lien your net recovery will be reduced.


  3. Although there is a "statutory" or automatic lien due to Federal law when Medicare/Medicaid is used (relating to a personal injury claim/settlement), whether or not there is actually a lien is very fact specific. Sometimes there is no requirement to pay when the lien is not asserted, and sometimes it doesn't matter, you and any party will be responsible to pay it. My suggestion to you would be to discuss the matter with your personal injury attorney in Texas. Good luck.

    THIS RESPONSE DOES NOT IMPLY OR CREATE AN ATTORNEY-CLIENT RELATIONSHIP. NO ATTORNEY-CLIENT RELATIONSHIP IS IMPLIED OR CREATED BY RESPONDING OR FAILING TO RESPOND TO THIS RESPONSE. THIS RESPONSE DOES NOT PROVIDE LEGAL ADVICE. FOR LEGAL ADVICE, YOU SHOULD CONSULT AN ATTORNEY.

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