What happens if I receive Medicare or Medicaid?

Although Medicare and Medicaid sound similar, the programs are vastly different. Medicare is a federal program. Medicaid is managed by state governments. The Department of Public Health and Human Services manages Montana's Medicaid program. Following the introduction of the Affordable Care Act, Medicaid significantly expanded to cover more Montanans. Individuals who earn as much as three and four times the poverty rate may qualify for Medicaid. You may now qualify for Medicaid and not realize it. If you are earning less than $75,000 a year, it is worth your while to contact Montana’s Medicaid program to determine if you and your family qualify. Further, your children may qualify for the CHIPS program even if you and your spouse do not qualify for Medicaid.

Under Montana law, Medicaid may claim reimbursement for medical bills it paid for injuries sustained in an automobile collision. If you receive Medicaid benefits and any medical bills you incur as a result of an automobile collision are paid by Medicaid, Medicaid must be made aware of the automobile insurance claim so it can request reimbursement.

It is extremely important that you submit all your medical bills to Medicaid if you are a Medicaid recipient. Medicaid will immediately take care of your bills, allowing you peace of mind. The amount of money that Medicaid expects in reimbursement is significantly less than the amount of the bill. As I explain below, the bodily injury insurance policy of the driver who hit you is required to pay all your medical bills up front. If you have another method or means of paying these medical bills, the full amounts of the bills will be taken out of your potential automobile insurance claim. In short, as with health insurance, Medicaid recipients should submit all their medical bills to Medicaid for coverage. It is a waste for any Medicaid recipient to not submit all their bills to Medicaid.

Like Medicaid, Medicare also has a right to reimbursement for a portion of the medical bills that it pays related to an automobile collision. As with Medicaid, Medicare is willing to negotiate a settlement of the medical bills. For this reason, and for the same reasons Medicaid recipients should submit their bills to Medicaid, all Medicare recipients should also submit all medical bills to Medicare. Because reimbursement may be required, Medicaid and Medicare recipients must not spend money received for medical bills until a settlement is reached with the governmental organization. Both Medicaid and Medicare are willing to reduce the reimbursement amount to a figure that considers attorney fees and other expenses. In my experience, Medicaid and Medicare are first and foremost happy they are notified of the potential for reimbursement.