Medicaid is a low-cost or no-cost medical insurance for Pennsylvanians with low income or certain needs. If you qualify for Medicaid, it can help you get medical care – but can it help you get your injuries covered after a personal injury?
Accidents can often be blamed on another party, such as a dangerous driver who hit you or a property owner who failed to keep their property safe. In these cases, you can often sue the person who caused your accident and get a court to order them to pay for your medical care related to the accident. If you go to the doctor after an injury and try to get care with your Medicaid coverage, it might be covered to the normal extent that it covers your care without an injury or accident, leaving you to still pay deductibles, co-pays, and other out-of-pocket costs. When you sue an at-fault party after an accident, we can work to get all of those out-of-pocket costs paid for instead of requiring you to pay for them through Medicaid.
For a free case evaluation after an injury, call the Pennsylvania personal injury lawyers at The Reiff Law Firm today at (215) 709-6940.
Does Medicaid Cover Personal Injury Care in Pennsylvania?
When you are in an accident or suffer injuries because of someone else’s negligence, we refer to this as a “personal injury” case. This classification usually does not prevent you from getting medical care as you normally would, whether that means paying out of pocket, using private health insurance, or relying on Medicare or Medicaid. When you go to the hospital or your doctor, you simply give them your insurance or Medicaid info as you normally would, and they will bill you and the insurance carrier the appropriate amounts based on your policy/coverage.
However, it is important to remember that, ultimately, someone else might be responsible for your injuries. This means that, after a lawsuit, our Philadelphia personal injury lawyers may be able to recover compensation for the medical bills you faced, making the at-fault party or parties pay for them instead of you. If you initially paid with Medicaid, you might only get your out-of-pocket payments covered, versus initially billing the at-fault party’s insurance might result in direct payment of all of those bills. Additionally, Medicaid might sometimes refuse to pay unless all other insurance options are used up first, including things like your car insurance after a crash or the at-fault party’s car insurance, homeowners’ insurance, etc.
Does Medicaid Get Reimbursed After Paying for My Personal Injury Damages in Pennsylvania?
Lawsuits can often be confusing and complex when medical care costs have already been paid by your health insurance or Medicaid. While you might be allowed to go to the doctor, pay with your Medicaid, and get the services you need, and then worry about getting compensation later, this can complicate matters. Since the at-fault party should be the one ultimately paying for your medical costs, Medicaid might want to seek reimbursement for the money they initially paid out for your treatment. This could give them rights to a “subrogation” claim, where they can claim back the amounts they spent on your care from the at-fault parties (or from you directly).
Where to Seek Treatment After an Accident in Pennsylvania
One important thing to remember is that not all care providers are set up to accept this kind of “third-party billing,” where they bill the at-fault driver’s car insurance, your employer’s Workers’ Compensation insurance, or some other insurance policy. If the provider knows that your injuries are related to a personal injury case, they might turn you away and tell you to seek treatment at a hospital. Additionally, some providers do not take Medicaid, but all hospitals should. For both of these reasons, your first stop for treatment after an injury should likely be a hospital rather than an urgent care clinic, your normal doctor, or any other care facility or clinic.
Getting Compensation for Medical Care in a Lawsuit in Pennsylvania
We have mentioned a few times now that the “at-fault parties” could be the ones to pay for your damages, but it is important to understand how this works. After someone causes an injury through negligence, recklessness, or intentional actions, the victims can often sue them for damages. This should get any economic and non-economic harms they faced paid for, including medical care costs, lost wages, and pain and suffering damages. If you were injured in an accident, then our attorneys can help you file a lawsuit to get your damages paid, all without having to tap into your Medicaid.
Accidents happen for all sorts of reasons, but many are preventable. If your injuries only happened because of someone else’s carelessness or recklessness – or if they injured you intentionally – then we often have legal grounds to sue them. For example, if a property owner left their sidewalk covered in snow for an unreasonable amount of time, and you slipped and fell in it, then they would be responsible for your damages. The same is true if a driver ran a red light and hit you, if a doctor failed to provide adequate medical care and you got sicker, or if a product manufacturer produced a defective product. All sorts of personal injury cases exist, and many of them can lead to lawsuits.
Other Insurance Coverage for Medical Care After an Accident in Pennsylvania
Instead of a lawsuit, most cases do involve some sort of insurance coverage. For example, drivers must have car insurance, many homeowners have homeowners insurance, and employers must have Workers’ Compensation insurance. In some of these cases, lawsuits are not allowed because of the insurance scheme in place, but in many, there are excuses that do still allow for lawsuits against at-fault parties.
Some accidents are also covered by first-party insurance, where you can use your own insurance instead of having to make a claim against the at-fault party. For example, your car insurance might cover your own injuries after an accident, saving you from having to use Medicaid, health insurance, or out-of-pocket payments to cover your treatment.
Whether you get coverage for your accident through insurance or a lawsuit, damages for medical care costs are almost always included, though there may be some limits on coverage or deductibles you have to pay first.
Call Our Pennsylvania Personal Injury Lawyers for Help Today
Call The Reiff Law Firm’s West Chester, PA personal injury lawyers for help with your accident case today by dialing (215) 709-6940.
