Medicaid benefits help people who cannot pay for health insurance or sky-high medical bills. Medicaid eligibility depends on income and the number of dependents, so it’s natural to wonder what happens to your coverage if you win a personal injury claim.

This is an essential question that our Indianapolis-based personal injury law firm Wagner Reese, LLP, often sees in cases. The Wagner Reese law firm is one of Indiana’s leaders in personal injury law. You can always turn to our attorneys for the most compensation in any personal injury claim, including motor vehicle accidents, medical malpractice, product liability, and dog bite injuries.

Our personal injury attorneys are among the elite in the field. Several of our personal injury attorneys were recognized with Super Lawyers® or Rising Stars® status in 2020. Only a few attorneys in the state have been named to these lists.

Also, founding partners Stephen Wagner and Jason Reese are among Indiana’s Top 25 Super Lawyers® and Best Lawyers®. Our injury law firm takes immense pride in obtaining the most compensation for our clients while balancing the payout with any government benefits you qualify for. After learning about Medicaid benefits and your personal injury claim, contact one of our attorneys with any follow-up questions.

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Medicaid Eligibility Requirements

You can receive Medicaid coverage through the Healthy Indiana Plan, the state’s version of Medicaid. These are the eligibility requirements for 2023:

  • 208% of the federal poverty level (FPL) for minors up to one year old.
  • 158% of FPL for children between one and 18. The Children’s Health Insurance Program (CHIP) pays for children at higher income levels (250% of FPL maximum).
  • 208% of FPL for women who are pregnant.
  • 138% of FPL for additional adults who are under 65.

Many people in Indiana receive Medicaid benefits to help with Medicare premiums, prescription drug costs, and various costs that Medicare doesn’t cover.

How A Personal Injury Claim Affects Medicaid Benefits

Being injured in an accident because of another party’s negligence can leave you with medical bills, lost earnings, and tremendous pain and suffering. You may have a well-justified need for compensation in a lawsuit. However, receiving a personal injury settlement could increase your assets in the eyes of the U.S. government.

Specifically, receiving an unstructured personal injury settlement may put you over the asset limits for Medicaid. This may result in you being disqualified for the program. Without careful legal planning, you could be barred from receiving future benefits if you receive a settlement during the Medicaid eligibility period.

When A Personal Injury Claim Can Affect Medicaid Benefits

Getting a personal injury settlement after an accident doesn’t automatically disqualify you from Medicaid. That said, your settlement compensation could be classified as resources or income that affects Medicaid eligibility.

If a car accident victim receives a $100,000 personal injury settlement in a lump sum, it could be counted as income in the month the funds are received. This could increase the person’s income above Medicaid eligibility for the month, affecting their Medicaid benefits.

In some cases, the Medicaid program might be entitled to recover some or all of your personal injury settlement through subrogation or a lien. This means the program could have a right to part of your settlement to reimburse Medicaid for your injury-related medical expenses.

How To Preserve Medicaid Benefits When Filing A Personal Injury Claim

If Medicaid initiates a lien or subrogation claim, it is essential to retain an experienced attorney. A Wagner Reese attorney can open negotiations with Medicaid to reduce the amount that the program claims. In some cases, it could be possible to negotiate a lower repayment or even have the Medicare lien waived.

How A Structured Settlement Can Help

One way to reduce how a personal injury settlement affects your Medicaid qualifications is to set up a structured settlement. This is a financial arrangement where settlement funds are paid over years rather than in a lump sum.

A structured settlement can avoid a lump sum settlement’s income and resource issues. If your attorney sets up a structured settlement payment schedule, the funds may not be considered income for the month you receive them. They also may not be viewed as resources for months in the future. Therefore, you can maintain your Medicaid benefits and eligibility. However, a structured settlement might not be the right fit for every case.

Another option could be to set up a special needs trust to retain your benefit eligibility. This legal arrangement would allow the settlement funds to be held to benefit a person with disabilities while safeguarding their Medicaid eligibility.

Seek Professional Legal Advice If You Receive Medicaid Benefits

This article shows that the issue of Medicaid benefits and receiving a personal injury settlement is complex. Speaking to a Wagner Reese personal injury attorney is vital if you receive Medicaid benefits and seek compensation in a personal injury lawsuit. Our attorneys are highly skilled and experienced in Medicaid law related to personal injury litigation. We will outline the options for preserving Medicaid benefits in personal injury claims.

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Our Wagner Reese Accident Injury Lawyers Can Help You

When you work with Wagner Reese personal injury attorneys, we will fight for the best compensation for your injuries. We will also determine the best legal and financial options for structuring a potential settlement in a way that maintains your Medicaid benefits.

Our lawyers have a proven record of obtaining excellent results for our personal injury clients. For instance, many of our personal injury lawyers have been named Super Lawyers® or Rising Stars. This is a notable achievement that only a tiny percentage of lawyers enjoy. Also, one of our founding partners, Stephen Wagner, has been honored as one of the Top 50 Personal Injury Attorneys in Indiana by Super Lawyers®.

Wagner Reese will work tirelessly to obtain the most compensation for your losses while determining the ideal way to maximize your recovery while maintaining Medicaid eligibility. For additional information about a personal injury settlement and its impact on Medicaid benefits, please call today.