Ohio Medicaid will cover emergency and follow-up care for injuries suffered in a personal injury. These injuries may be caused by a car crash, truck accident, dog attack, slip and fall at work, or any other accident that would give you grounds for pursuing and filing a personal injury claim. You do not need to worry about paying all the medical expenses incurred upon you by someone else’s negligence or careless behavior. That being said, Medicaid will demand reimbursement from any settlement or financial award you receive, but will only take an amount equal to what it spent in covering your care. In most cases, you will hold onto some or all of the compensation you received for lost wages and future earnings, pain and suffering, and, when they exist, punitive damages. Each government benefit functions a little differently, therefore it is important to have an attorney that can help you understand the impact of a settlement and what you can do to eliminate or at least minimize a possible reduction in your benefits.
What Does the Law Say?
Section 5160.37(A) of the Ohio Revised Code stipulates that:
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 Does the Law Mean?
Let’s make the above a little easier to understand; The third party referenced in the Ohio statute is the insurance company for the person(s) or company that caused your personal injury. The amount of your settlement or monetary award that you will need to reimburse to Ohio Medicaid depends on several factors. It depends on how much Medicaid paid for your injury-related medical care services. It also depends on whether or not you are enrolled in a Medicaid managed care plan, and whether your settlement or award includes a monetary amount specifically for medical expenses.
No outcome can be guaranteed. However, an experienced personal injury attorney will fight to ensure that a settlement or jury award accounts for all of Medicaid’s spending. For your personal injury case, your attorney will have the confidence and know-how to negotiate and work with the insurance company and the Ohio Department of Medicaid to manage the reimbursement. We spare you from having to engage in stressful negotiations and complicated paperwork so that you can focus your time and energy on recovery and healing.