Does a Personal Injury Settlement Affect Medi-Cal Coverage? - An Expert's Perspective

A personal injury settlement will not have any negative effect on the injured party's Medi-Cal coverage. The program is structured like any other health insurance, so that the injured person does not receive double benefits for the same injuries. A Medi-Cal garnishment can only affect the part of the agreement that compensates for medical expenses. This means it cannot affect the damages received for lost wages or pain and suffering.

The garnishment is limited to the original amount Medi-Cal paid for treatment. Additionally, the DHCS has the power to compromise, resolve, or waive lien claims. For instance, your Medi-Cal claim can be reduced if you have to pay attorney fees or litigation costs. When resolving a serious injury case, the parties will review and consider future medical treatment.

In some cases, Medi-Cal is the only source of funding for expensive long-term care. To stay within the asset limit and protect ongoing access to Medi-Cal, the agreement usually includes a structured agreement, a special needs trust, or both. Making Medi-Cal pay for medical treatment related to a personal injury is something of a “good news and bad” situation. The Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for administering Medicare, takes the position that Medicare's “future interests” must be reasonably protected in a personal injury settlement (see 42 U.

Reporting any errors like this will help verify that the personal injury claimant is responsible for reimbursing treatment that was definitely related to an accident). However, when it comes to personal injury compensation amounts, some regional CMS offices (such as the San Francisco office) refuse to review an MSA of a personal injury claim (which is called “LMSA” (MSA of Liability). When a personal injury victim receives medical care for their Medicare-covered injuries, health benefits are refundable based on any agreement, award, or verdict that they may receive. If you file a personal injury lawsuit as a member of Medi-Cal, you must notify the California Department of Health Services (DHCS) within 30 days of filing the lawsuit.

It's always important to carefully review the detailed list of benefits that Medicare seeks reimbursement for; most people with Medicare are likely to receive routine or ongoing medical care that has nothing to do with the accident injury for which they file a personal injury claim. He is a nationally recognized expert in special needs and settlement planning laws for the elderly, minors and people with disabilities. Medi-Cal's right to collect allows them to seek reimbursement from personal injury settlements for treatment funds. Wilshire Law Firm is an award-winning personal injury law firm that has been serving its clients for nearly 15 years.

There has been much discussion recently about what lawyers and their clients who receive Medicare should do to “reasonably protect Medicare's future interests” in the context of a personal injury settlement. After a personal injury settlement, you don't want to lose your Medicaid or Medi-Cal benefits. While not an expression of the law or of CMS's global policy, this memo explains the issues that arise when resolving a plaintiff's personal injury claim. And since more than a third of Americans are covered by one of these two health insurance programs, Medicare and Medi-Cal reimbursements are very common in personal injury claims.

Blane is a personal injury law firm in San Diego, California dedicated to representing families of people injured in accidents involving personal injuries, including car accidents, slip and falls, dog bites, product defects, and the like. Counseling a client and connecting them with MSA experts is an essential service that an experienced personal injury lawyer can provide. It is important to understand how your settlement may affect your access to Medi-Cal coverage and other benefits.

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