Medicaid Lien & Personal Injury Settlement

medicaid liens personal injury settlements

If you are a Medicaid recipient and you’re injured, your insurance policy may cover the cost of your medical care. However, if you’ve filed a personal injury claim within Illinois statute of limitations and you have a successful personal injury claim or medical malpractice claim, you’ll receive judgment or settlement funds. With these funds, you must repay Medicare, Medicaid or any other healthcare providers for any debts owed, as a result of the injury. 

These will be terms you’ll discuss in your personal injury settlement meeting or mediation.

Illinois Personal Injury Settlements and Healthcare Liens

In Illinois, when someone settles a personal injury claim, they may also have one or more healthcare liens against the amount of recovery. Medical providers who have treated or rehabilitated the injured may assert liens against the personal injury settlement.

Per the Health Care Services Lien Act, any:

  • licensed hospital,
  • treatment facility,
  • doctor or
  • physical therapist

who has provided medical services may elect to place a lien on the claim.

After a successful personal injury claim, the injured receives his or her compensation through settlement or judgement. And, the total of all healthcare liens cannot exceed 40% of the total recovery. Furthermore, no single group can receive more than 1/3 of the total recovery. If the total amount of liens exceed 40%, the liens will reduce. The total of all healthcare professionals' liens in this case, cannot exceed 20% of the recovery. And, the total of all healthcare providers' liens cannot exceed 20% of the recovery.

Payments by Illinois Department of Public Aid, Medicare or Medicaid extinguish the healthcare provider's right to further payment through a lien. If Medicaid covers the injured person, by state law, healthcare providers must accept this, as a form of payment.

Certain liens, in Illinois, hold "super lien" status. Two of these include Medicare and Medicaid. If the injured is a Medicare beneficiary and Medicare pays for the treatment, Medicare has a right to be reimbursed.

After the recovery, the injured has 60 days to repay Medicare--their reimbursement takes priority over all other healthcare providers. If the recovery came from a settlement or trial, Medicare reduces its recovery by the amount that the injured spent in order to secure the recovery.

For wrongful death claims, Medicare can only recover reimbursement against the damages for medical expenses.

Medicaid can also place a healthcare lien on your recovery. But, the amount of the reimbursement is more limited, in this case. Medicaid can only demand reimbursement against the portion of your recovery that was designated for medical expenses. This means Medicaid excludes any portion of your recovery for lost wages, past or future pain, or disability from this amount.

Medicaid Liens and Personal Injury Lawsuit Settlements in Chicago

When you’ve been injured, don’t stress over Medicare or Medicaid liens against your personal injury settlement. Instead, focus on getting better! An experienced personal injury attorney can ease the stress and help you fight for your right for fair compensation.

Curcio & Casciato serves the Chicago and surrounding areas and offers free initial consultations. Call us today at 312-321-1111.

Share this post