- Yes — If you’re a Medicaid recipient and receive treatment by a provider enrolled in the Medicaid program, Medicaid will pay your medical bills at a greatly discounted rate—regardless of who was at fault for the accident.
- When you are injured in an accident that was not your fault and use Medicaid to pay for your treatment, Medicaid will put a lien on the amount it paid—this must be reimbursed at the time of settlement.
- You must only reimburse what Medicaid pays the provider, which is always less than what patients will pay out of pocket because providers and hospitals bill Medicaid at a discounted rate.
- Because Medicaid only pays covered medical expenses, you will need to pursue a claim against the at-fault driver’s insurance carrier to recover the full cost of the accident.
If you’re injured in a car accident, the cost of medical care can be a tremendous burden on you and your family. When another driver is to blame for the accident, you may have an injury claim against their auto insurance company. However, even if someone else is ultimately held responsible, settling a claim can take time, and your medical bills aren’t going to wait until you get paid.
An accident victim is better off having their own health insurance pay medical bills as they come in, but for millions of Americans who can’t afford health insurance, Medicaid may be the only means available to pay some or all of their medical bills after an accident.
What is Medicaid?
Medicaid is a medical assistance program that is jointly funded by federal and state governments and provides coverage to more than 70 million low-income people across the United States. Almost 2 million Medicaid recipients live in Georgia and depend on this program to pay for treatment by doctors, hospitals, and other medical providers.
You may be eligible for Medicaid if your income is low, and you meet one of the following criteria:
- You are pregnant
- You are a minor
- You are 65 or older
- You are legally blind or have another disability
- You need nursing home care
Keep in mind that this list is not exclusive; there are other situations that could make you eligible for Medicaid. If you or someone in your family needs health care, you can apply for Medicaid even if you’re not sure whether you qualify. Your income and situation determine which Medicaid group you would be placed in, and your group determines whether Medicaid pays for all or only some of your medical costs.
Does Medicaid Cover Medical Expenses Resulting from Car Accidents?
When you’re injured in a car accident through no fault of your own, the driver who caused the crash is responsible for paying your costs. These costs include not only medical treatment but also losses such as pain and suffering, lost wages, and diminished quality of life. Any settlement you receive from the at-fault driver’s insurance company should include the total cost of the accident to make you whole.
Often, medical costs are the biggest expense after a car accident. Unfortunately, it can take months or even years to settle or litigate your injury claim—and medical bills can pile up while you’re waiting for resolution. If you have health insurance or Medicaid coverage, you should submit your bills for payment as they come due rather than wait until after you agree to a settlement. Most hospitals and providers will opt to bill Medicaid for your care instead of waiting for the other party’s insurance to pay.
If you’re a Medicaid recipient and receive treatment by a provider enrolled in the Medicaid program, Medicaid will usually pay your medical bills at a greatly discounted rate—regardless of who was at fault for the accident. And even though the bills are paid at a discounted rate, in the State of Georgia (as of 2023) you are entitled to claim the original undiscounted billed amount from the at-fault driver’s insurance company.
Keep in mind that Medicaid only pays for your medical costs—not your pain and suffering and other accident-related losses, such as lost income and diminished quality of life. You will need to pursue a claim against the at-fault driver’s insurance carrier to receive full compensation for the accident. If the other driver is uninsured or underinsured, Medicaid will still pay your medical bills, but you may have to file a lawsuit to get fully compensated for all your losses.
If you caused the accident, and you have Medicaid coverage, Medicaid should pay your costs – similar to private health insurance, Medicaid will not cover the other driver’s medical costs if you injure them. You or your liability insurance carrier may be responsible for that.
Will Medicaid Subrogate the Car Accident Medical Bills?
If you are injured in an accident that was not your fault and use Medicaid to pay for your treatment, Medicaid may put a lien on the amount it paid. After you agree to a car accident settlement, this lien must usually be paid at the time of settlement. This process is called subrogation.
Medicaid and insurance companies use subrogation because the law allows them to be reimbursed after paying the costs when someone else was to blame for causing your injuries.
What if a Car Accident Victim Is Treated at a Hospital That Doesn’t Accept Medicaid?
If you have injuries that require hospitalization, you should not avoid or delay getting medical treatment after a car accident. Hospitals may not deny you medical services based on your ability to pay, which means you can receive treatment even if you have no medical insurance or are not enrolled in Medicaid.
However, if you are treated by a medical provider or hospital that doesn’t accept Medicaid, then Medicaid will not pay for the services. That means you will be billed for the cost of that medical care. If the hospital does accept Medicaid, you may still have to make a copayment depending on your Medicaid group.
Fortunately, many hospitals and medical providers who treat car accident victims understand that some patients can’t pay because they don’t have coverage through Medicaid or health insurance. Those providers may arrange a deferred payment plan, which means the provider agrees to treat the patient in exchange for a promise to pay the bills from the accident settlement. Alternatively, the hospital or provider may also get a medical lien to ensure that the cost of treatment is reimbursed.
I want to take this opportunity to thank you for the wonderful help you gave me during my time of crisis after my accident. You checked on me you made sure that all my needs were accommodated and I really appreciated that. It was a very difficult time for me and you make sure that everything worked out and I really want to thank you.
Consultations Are Free at The Millar Law Firm
If you or a loved one has been injured in a car accident and receive Medicaid, you should speak to an experienced personal injury lawyer about your claim. Call The Millar Law Firm at (770) 400-0000 or contact us online to set up a free consultation with one of our attorneys.