TSV(R) Preview
16 Members and 15504 Guests Online

Viewpoints

Can You Sue While On Medicaid

Started 1301321773.277 in Viewpoints | Last reply 1301371239.6 by happy2write4u

I think that if you do and win you have to reimburse the goverment for all your medical bills, of course I may be wrong...

2cutetwins until board changed..

Page 1 of 2
happy hous­ewife1301322127.832604 PostsRegistered 1/4/2007

I would think that is correct. when my dad was in the hospital after being in a car accident he had to pay back medicare and Blue Cross for his medical care when the car insurance co paid off. I know people assumed we made alot of money from this accident but in fact there was hardly any after paying off $425,000 in medical bills. Now, because he was a decorated veteran the VA paid for his care in the nursing home and they did not ask for any money back. But the VA has gotten stingy since then - they hardly take care of anyone unless they are indigent.

When faced with senseless drama, spiteful criticism or misguided opinions walking away is the best way to defend yourself.To respond with anger is an endorsement of their attitude. -Dodinsky

LipstickDi­va1301325484.1639164 PostsRegistered 4/22/2005On the Lake in Ohio

If someone sues for say an auto accident and bills were paid by their health insurance, medicare or medicaid, we have to find out how much and reimburse them for the medical bills paid, before our client gets any of the settlement.

You can't buy love but you can adopt it. Adopt, don't shop.

snap-crack­le-pop1301325648.3274588 PostsRegistered 9/10/2006
On 3/28/2011 Queen of Posts said:

If someone sues for say an auto accident and bills were paid by their health insurance, medicare or medicaid, we have to find out how much and reimburse them for the medical bills paid, before our client gets any of the settlement.

Queens a family I know who has lost their father was in a hospital for a transplant..I think medicaid covered it all..

2cutetwins until board changed..

esmerelda1301325708.1314409 PostsRegistered 10/6/2004

I don't think one gives up any rights when using Medicare.

And if you do have to pay them back, isn't that the right thing to do? After all part of your suit is to recover medical costs. If you didn't pay them, why should you get that part of a settlement?

Nothing fuels bravery more than the lack of the will to live. ~Lovers at the Chameleon Club, Paris 1932: A Novel (Francine Prose)

wookie1301325816.998920 PostsRegistered 4/30/2006

I would think any patient harmed by malpractice would receive any funds remaining after legal and medical expenses are deducted.

Last edited on 3/28/2011

Last edited on 3/28/2011

ChoosandMa­nolos1301326147.4175013 PostsRegistered 7/2/2006

Any proceeds from the lawsuit are considered assets and would therefore have to be turned over to the state's Medicaid office. On Medicaid you are only allowed assets of about 4K total.

LipstickDi­va1301326829.12339164 PostsRegistered 4/22/2005On the Lake in Ohio

SCP, it would be the same deal. If they sue for malpractice, medicaid would be paid back from any proceeds rec'd from the lawsuit before disbursement was made to the plaintiff. Sometimes that amount can be negotiated down. Also prior to disbursement of funds to the plaintiff, legal fees and costs come out as well.

You can't buy love but you can adopt it. Adopt, don't shop.

minkbunny1301327131.3627511 PostsRegistered 7/15/2007

If you sue while on Medicare they will have to be paid back for the money they spent for your medical care. We have had more than one attorney try to talk my husband into a malpractice suit as it was admitted by the emergency room that they erred in not finding 3 blood clots and an aneurysm and sending him home as "fine" just hours before he needed a 12 hour emergency surgery to restore some blood flow to his leg. Problem is our state has a cap of $350,000 for a malpractice claim and his bills have already far exceeded that.That and the aggravation we just don't need at this time. He could never sue while needing future surgery as he would then lose his surgeons as they are affiliated with the ultrasound office who did his testing.

We were told that the cap will change after he has an amputation or God forbid if there were a wrongful death claim.

The amount paid to Medicare is adjusted downward on a scale set by each state, we do it here in our office but I am not familiar with other states.

It would depend on the amount of the suit and the state statutes whether it would be financially advantageous.

minky

ETA, I just realized that I was referring to Medicare not Medicaid. I am not sure how that works.

Last edited on 3/28/2011

Last edited on 3/28/2011

My heroes have always been cowboys, and they still are it seems.
_______________________________

“Once in a while right in the middle of an ordinary life,
love gives us a fairy tale”

minkbunny1301329275.3327511 PostsRegistered 7/15/2007

Just pulled a letter from one of our personal injury client's files.

It reads in part

From the Centers for Medicare and Medicaid Services

This letter follows a previous letter notifying you/your attorney of Medicare's priority right of recovery as defined under the Medicare Secondary Payer provisions. Because you were involved in an automobile, slip and fall, medical malpractice, or some other type of liability claim, the medical expenses are subject to reimbursement to Medicare from proceeds received pursuant to a third party liability settlement, award, judgment, or recovery.

minkySmile

My heroes have always been cowboys, and they still are it seems.
_______________________________

“Once in a while right in the middle of an ordinary life,
love gives us a fairy tale”

Justreading1301329361.8193 PostsRegistered 5/19/2010

I think regardless it is Medicaid or private insurance when a lawsuit is won or settled the insurance company is paid back as it should be. As usually what your suing for is medical past and present, pain, suffering etc.

snap-crack­le-pop1301329459.6774588 PostsRegistered 9/10/2006
On 3/28/2011 minkbunny said:

Just pulled a letter from one of our personal injury client's files.

It reads in part

From the Centers for Medicare and Medicaid Services

This letter follows a previous letter notifying you/your attorney of Medicare's priority right of recovery as defined under the Medicare Secondary Payer provisions. Because you were involved in an automobile, slip and fall, medical malpractice, or some other type of liability claim, the medical expenses are subject to reimbursement to Medicare from proceeds received pursuant to a third party liability settlement, award, judgment, or recovery.

minkySmile

Thanks Minky..the person did pass away so I am sure the family has no idea they would have to pay the goverment back for the hospital bills..The poor man was in the hospital 8 weeks before his death..

2cutetwins until board changed..

beach music1301329514.2829065 PostsRegistered 4/16/2007

no one ever loses the right to sue... collecting is another thing entirely.

"don't get so tolerant that you tolerate intolerance." bill maher

minkbunny1301329590.5827511 PostsRegistered 7/15/2007
On 3/28/2011 snap-crackle-pop said:
On 3/28/2011 minkbunny said:

Just pulled a letter from one of our personal injury client's files.

It reads in part

From the Centers for Medicare and Medicaid Services

This letter follows a previous letter notifying you/your attorney of Medicare's priority right of recovery as defined under the Medicare Secondary Payer provisions. Because you were involved in an automobile, slip and fall, medical malpractice, or some other type of liability claim, the medical expenses are subject to reimbursement to Medicare from proceeds received pursuant to a third party liability settlement, award, judgment, or recovery.

minkySmile

Thanks Minky..the person did pass away so I am sure the family has no idea they would have to pay the goverment back for the hospital bills..The poor man was in the hospital 8 weeks before his death..

Hi snap, they may not and they definitely won't have to pay the amount they are billed. They should probably see an attorney. I never even thought of it until we got involved either.Smile

My heroes have always been cowboys, and they still are it seems.
_______________________________

“Once in a while right in the middle of an ordinary life,
love gives us a fairy tale”

snap-crack­le-pop1301330684.2174588 PostsRegistered 9/10/2006
On 3/28/2011 minkbunny said:
On 3/28/2011 snap-crackle-pop said:
On 3/28/2011 minkbunny said:

Just pulled a letter from one of our personal injury client's files.

It reads in part

From the Centers for Medicare and Medicaid Services

This letter follows a previous letter notifying you/your attorney of Medicare's priority right of recovery as defined under the Medicare Secondary Payer provisions. Because you were involved in an automobile, slip and fall, medical malpractice, or some other type of liability claim, the medical expenses are subject to reimbursement to Medicare from proceeds received pursuant to a third party liability settlement, award, judgment, or recovery.

minkySmile

Thanks Minky..the person did pass away so I am sure the family has no idea they would have to pay the goverment back for the hospital bills..The poor man was in the hospital 8 weeks before his death..

Hi snap, they may not and they definitely won't have to pay the amount they are billed. They should probably see an attorney. I never even thought of it until we got involved either.Smile

Minky I think they have contacted an attorney.. Transplants are still rare and I am not sure what you have to sign away just to receive one..I have tried to explain that to them but they are determined....thanks scp{#emotions_dlg.wub}

2cutetwins until board changed..

happy hous­ewife1301334780.0732604 PostsRegistered 1/4/2007
On 3/28/2011 minkbunny said:
On 3/28/2011 snap-crackle-pop said:
On 3/28/2011 minkbunny said:

Just pulled a letter from one of our personal injury client's files.

It reads in part

From the Centers for Medicare and Medicaid Services

This letter follows a previous letter notifying you/your attorney of Medicare's priority right of recovery as defined under the Medicare Secondary Payer provisions. Because you were involved in an automobile, slip and fall, medical malpractice, or some other type of liability claim, the medical expenses are subject to reimbursement to Medicare from proceeds received pursuant to a third party liability settlement, award, judgment, or recovery.

minkySmile

Thanks Minky..the person did pass away so I am sure the family has no idea they would have to pay the goverment back for the hospital bills..The poor man was in the hospital 8 weeks before his death..

Hi snap, they may not and they definitely won't have to pay the amount they are billed. They should probably see an attorney. I never even thought of it until we got involved either.Smile

medicare negiotiated a lower settlement for us but Blue cross did not - they were reimbursed the total amount they had paid.

When faced with senseless drama, spiteful criticism or misguided opinions walking away is the best way to defend yourself.To respond with anger is an endorsement of their attitude. -Dodinsky

tessan1301335134.71211 PostsRegistered 8/11/2007

why are they suing?

CAROLINA21301335949.111181 PostsRegistered 5/28/2010

Thanks for the interesting questions and answers. I never even thought of that problem Good to know what to do.

snap-crack­le-pop1301336966.1674588 PostsRegistered 9/10/2006
On 3/28/2011 tessan said:

why are they suing?

Don't know all the details but a sponge was left in and not found for a few days..don't think that was what killed him.. I heard the hospital made many mistakes??

2cutetwins until board changed..

tessan1301337460.1631211 PostsRegistered 8/11/2007
On 3/28/2011 snap-crackle-pop said:
On 3/28/2011 tessan said:

why are they suing?

Don't know all the details but a sponge was left in and not found for a few days..don't think that was what killed him.. I heard the hospital made many mistakes??

well that will be difficult to win. anyone can sue. but they'll have to prove the sponge left in contributed to or caused his death. and I'm sure the informed consents signed for the surgery listed many, many risks, including death.

minkbunny1301339144.4927511 PostsRegistered 7/15/2007

You are welcome snap. I wish the family well, a lot to deal with. The mound of paperwork along is mind boggling.{#emotions_dlg.huh}

My heroes have always been cowboys, and they still are it seems.
_______________________________

“Once in a while right in the middle of an ordinary life,
love gives us a fairy tale”

LipstickDi­va1301339174.4439164 PostsRegistered 4/22/2005On the Lake in Ohio

SCP, one of the first cases I helped one of my bosses with at my old firm was a malpractice case from a sponge being left in a woman.

Just fyi, the attorney most certainly should know that medicaid has subrogation rights. However, there are attorneys who don't bother with it and don't bother to tell the client, leaving that client in a very bad situation when someone comes knocking for their money.

You can't buy love but you can adopt it. Adopt, don't shop.

happy hous­ewife1301341874.68732604 PostsRegistered 1/4/2007
On 3/28/2011 Queen of Posts said:

SCP, one of the first cases I helped one of my bosses with at my old firm was a malpractice case from a sponge being left in a woman.

Just fyi, the attorney most certainly should know that medicaid has subrogation rights. However, there are attorneys who don't bother with it and don't bother to tell the client, leaving that client in a very bad situation when someone comes knocking for their money.

unfortunately, the lawyers get paid before anyone else SO they will file any suit they can win even if they don't think there will be money left over for the family because they will get paid FIRST. Meanwhile the family goes through alot of emotional baggage and all then they end up with little or nothing. The insurance co. gets their money back and the lawyers get paid and the injured party gets nada. Nice system.

Last edited on 3/28/2011

Last edited on 3/28/2011

When faced with senseless drama, spiteful criticism or misguided opinions walking away is the best way to defend yourself.To respond with anger is an endorsement of their attitude. -Dodinsky

snap-crack­le-pop1301343256.1534588 PostsRegistered 9/10/2006
On 3/28/2011 retiree said:
On 3/28/2011 Queen of Posts said:

SCP, one of the first cases I helped one of my bosses with at my old firm was a malpractice case from a sponge being left in a woman.

Just fyi, the attorney most certainly should know that medicaid has subrogation rights. However, there are attorneys who don't bother with it and don't bother to tell the client, leaving that client in a very bad situation when someone comes knocking for their money.

unfortunately, the lawyers get paid before anyone else SO they will file any suit they can win even if they don't think there will be money left over for the family because they will get paid FIRST. Meanwhile the family goes through alot of emotional baggage and all then they end up with little or nothing. The insurance co. gets their money back and the lawyers get paid and the injured party gets nada. Nice system.

Last edited on 3/28/2011

This is what I told one family member..The man was running out of time with out the transplant. Very sad all the way round. The wife is still only around 55 and this could drag on for years. And as I have told them this was a state hospital and their lawyers will have a very young small town lawyer knocked out the first round

2cutetwins until board changed..

thalmy1301343472.9132276 PostsRegistered 8/31/2009

If you sued and won, it would more likely than not make a person ineligible to continue to qualify for Medicaid. If Medicaid was due to disability, Medicare will stay in place and you'll have to pay for a private insurance policy to cover what Medicare doesn't pick up, or pay out of pocket for that.

I know a person who was/is disabled. They got an inheritance. They reported getting money and got them-self off Medicaid. Being retirement age, and still disabled, Medicare continued for them. They didn't need to pay for previous medical care under Medicaid. The did have to get a medi-gap policy though which they now pay for. They also lost assistance for the monthly charge for Medicare.

I suspect, why Medicaid was an insurer would be a large part of any decision. An SSD person might have a different outcome than an SSI recipient of Medicaid. If an SSI claimant, I imagine that monthly check would stop along with Medicaid.

I hope I didn't muddle things for you. A case worker is the only person that can answer your question.

Thom
Forever in our hearts.

happy hous­ewife1301356580.93332604 PostsRegistered 1/4/2007

And another thing is they base how large the settlement is on the expected income that is lost - so if the person who was injured was a retiree whose future earnings would have been very low then the settlement would be very low.In other words - my parents were retired and their income was low so the settlement of their suit was relatively low - partly because their income was low and partly because they were senior citizens already before the accident happened so their lifelong expected income had the accident not happened was also low.

a man who was probably on SSD and had a low probability of a very long life due to his illness and the chances of failure of a transplant being high - he would get a very low settlement.

When faced with senseless drama, spiteful criticism or misguided opinions walking away is the best way to defend yourself.To respond with anger is an endorsement of their attitude. -Dodinsky

Page 1 of 2