Medicaid and Personal Injury Settlements Ohio

Does Having Ohio Medicaid Coverage Affect My Personal Injury Settlement?

Yes, Medicaid does affect personal injury settlements.

No, this should not discourage anyone who has Medicaid coverage in Ohio from attempting to hold the person or company that caused their injuries accountable through insurance claims or a lawsuit.

Medicaid’s Role in Personal Injury Cases:

• Coverage for medical expenses: Medicaid will cover emergency and follow-up care for injuries resulting from accidents.
• Reimbursement from settlements: Medicaid will seek reimbursement for the costs it incurred in providing medical care.
• Reimbursement limits: The reimbursement amount is generally limited to the actual costs paid by Medicaid.

How much will medicaid take from my settlement in Ohio?

The amount Medicaid will take from your settlement in Ohio depends on several factors, including

• The amount of medical assistance provided: Medicaid will typically seek reimbursement for the total cost of medical services it provided related to your injury.
• State-specific laws: Ohio’s laws generally limit Medicaid’s claim to the amount of medical assistance paid.
• Type of settlement: Whether the settlement is from a lawsuit or an insurance claim can also influence the reimbursement amount.

Will I lose my medicaid if I get a settlement?

No, you will not lose your Medicaid if you get a settlement.

While Medicaid may seek reimbursement for the medical expenses they covered related to your injury, this does not necessarily mean you will lose your Medicaid benefits altogether.

Medicaid Covers Now and Seeks Reimbursement Later

First, know that Ohio Medicaid will cover emergency and follow-up care for injuries suffered in a car crash, truck accident, slip and fall, dog attack, or other accident that would give you grounds for filing a personal injury claim. You do not need to worry about paying all the medical expenses forced upon you by someone else’s negligence or reckless behavior.

Can medicaid take my settlement money?

It is also true that Medicaid will demand reimbursement from any settlement or jury award you receive. The program will only take an amount equal to what it spent in covering your care, though. In most cases, you will hold onto some or all of the compensation you received for lost wages, loss of future earnings, pain and suffering, and, when they exist, punitive damages.

Can medicaid take my car accident settlement?

Yes, Medicaid can take a portion of your car accident settlement. If Medicaid covered any medical expenses related to your injuries from the car accident, they typically have the right to seek reimbursement from the settlement proceeds.

What the Law Says

• Ohio Revised Code Section 5160.37(A): This law outlines Medicaid’s right of recovery against third parties liable for medical expenses.
• Factors affecting reimbursement: The amount of reimbursement depends on factors like Medicaid’s spending, enrollment in a managed care plan, and whether the settlement includes specific medical expenses.

A medical assistance recipient’s enrollment in a medical assistance program gives an automatic right of recovery to the department of medicaid and a county department of job and family services against the liability of a third party for the cost of medical assistance paid on behalf of the recipient. When an action or claim is brought against a third party by a medical assistance recipient, any payment, settlement or compromise of the action or claim, or any court award or judgment, is subject to the recovery right of the department of medicaid or county department. Except in the case of a medical assistance recipient who receives medical assistance through a medicaid managed care organization, the department’s or county department’s claim shall not exceed the amount of medical assistance paid by the department or county department on behalf of the recipient. A payment, settlement, compromise, judgment, or award that excludes the cost of medical assistance paid for by the department or county department shall not preclude a department from enforcing its rights under this section.

What the Law Means

The ”third party” referenced in the state statute is the insurance company for the person or company that caused your personal injury. The amount and percentage of your settlement or jury award that Ohio Medicaid will take depends on several factors, including

• How much Medicaid paid for injury-related health care services,
• Whether you are enrolled in a Medicaid managed care plan, and
• Whether your settlement or award includes monies specifically for medical expenses.

Working with a Personal Injury Attorney:

While no outcome can be guaranteed, a personal injury attorney who represents a client who is covered by Medicaid will fight to ensure that a settlement or jury award accounts for all of Medicaid’s previous and projected spending. In every event, the attorney will work with the insurance company and the Ohio Department of Medicaid to arrange the reimbursement and spare their client from having to engage in negotiations and complete paperwork.

Corey Heit of Westerville-based Heit Law helps victims in all types of personal injury cases in and around Columbus, Ohio. He offers free consultations to prospective clients, and he can take appointments online or over the phone at (614) 898-5300.