If someone’s carelessness in Florida caused your injury, then you should apply for Medicaid immediately following an accident if you think that you may qualify.
Florida Medicaid provides medical coverage to low-income individuals and families.
I believe that Medicaid will pay your accident related medical bills retroactively (before the date Medicaid receives your application) for about 3 months or so prior to receiving your application if you get approved.
I arrived at the 3-month time frame based on an Internet search. Medicaid does a poor job of clearly stating on their website the exact time that Medicaid will pay retroactive benefits.
Below is an example of how someone can benefit by applying for Medicaid following a bad accident.
Example #1: Applying for Medicaid quickly after the accident
Joe is driving a car and crashes into Mike in Miami, Florida. Joe A is at fault for causing the accident. Mike’s upper leg (femur) is fractured and he has surgery at the hospital to repair it. Mike is treated by the following medical providers: fire rescue/ambulance, the hospital, anesthesiologist, ER, radiologist, pathologist (blood work) bills.
Mike hasn’t yet received any medical bills. Mike has very little money and may be considered a low-income individual. Mike gets a copy of the crash report and it shows that the Joe was driving a vehicle insured with State Farm.
While Mike is covered with PIP coverage, it will only pay for up to $10,000 of his medical bills. Let’s assume that the medical bills will be $140,000 given his inpatient hospital stay and surgery.
Mike doesn’t have health insurance. And like most Floridians, Mike is not an insured under any uninsured motorist coverage.
Since Mike may meet the guidelines to be eligible for Florida Medicaid, he should apply immediately.
If Florida Medicaid approves his application, then Medicaid will now pay for his accident related bills assuming the hospital bills Medicaid. The Florida hospital or doctor has the choice of whether or not to bill Florida Medicaid.
In addition to paying for future medical bills, Medicaid may possibly pay for medical bills retroactively for up to 3 months before Mike submitted his application.
As soon as Mike is approved by Medicaid, he should contact (preferably in writing) the medical providers who treated him and inform them that he has Medicaid.
Warning: Under Florida’s Medicaid Third-Party Liability Act, if benefits of a liable third party are discovered or become available after medical assistance has been provided by Medicaid, Florida Statute 409.910 states that Medicaid must be repaid in full and prior to any other person, program, or entity.
Tip: But before you pay Medicaid the amount that they are telling you that you owe them, you should understand how much you have to repay Florida Medicaid from an injury settlement.
When settling an injury case, you should factor in the fact that you will need to repay Medicaid once you get your settlement check(s) from the responsible party or parties. You should also continuously request a Medicaid lien and continuously and immediately provide it to any third parties who may provide benefits.
This will help the third party adequately set their reserve and have authority to offer you the fair settlement value when the case is ready to settle.
Typical third parties include but are not limited to are those who you can make a claim against in an auto accident, or possible third parties in a slip and fall or other type of injury case.
Example #2: Waiting too long to Apply for Medicaid after the accident
Let’s take the same facts as in Example #1 except Mike waits four months to apply for Medicaid. It may be too late for Medicaid to pay for his medical bills that were incurred over 3 months from when he applied to get Medicaid.
Now, Mike may be stuck with a $140,000 bill! So the lesson to be learned is quickly apply for Medicaid after an accident if you think that you may qualify.
Mike could pay $350 to Medical Bill Clinic (a law firm) and they will offer a billing analysis and opinion in a reasonable analysis for any hospital bill. This may be a great tool in negotiating an unreasonable hospital bill.
There is a chance that the party that injured Mike has enough liability insurance to cover the settlement value of Mike’s case.
In this case, it may actually benefit Mike if Mike’s medical provider’s do not bill Medicaid. This is because Mike’s medical bills will be higher which would increase the full value of his injury claim.
But you shouldn’t rely on the liable parties to have insurance coverage, as many Florida drivers are many uninsured. Many of the responsible parties are underinsured if you have significant injuries.
Remember: Do not assume that medical providers aren’t going to bill you because you haven’t received medical bills. They almost always will bill you even if you think that they forgot about you.
This is an article that can help you find Florida doctors that can treat you if you are injured in an accident.
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