Important Info For Florida Personal Injury Attorneys With Clients on Medicaid

Our Medicaid Planning Law Firm spends a significant amount of time helping Floridians who do not naturally qualify for Medicaid long-term care benefits– to protect their income and assets in order to become eligible for Medicaid to help pay for care at home or in a facility.

We also assist in the reverse situation. I.E. we represent many people who are receiving Medicaid benefits already, and are about to come into funds (usually from an inheritance, sale of their house, or personal injury settlement).

For my Florida personal injury lawyer colleagues, I recommend you read my previous article discussing how our firm can help their clients Avoid Losing Medicaid Benefits After Receiving a Personal Injury Settlement. It provides very practical information and discusses some of the general principles involved in spending down and otherwise preserving Florida Medicaid after coming into injury proceeds.

Suffice it to say that it is important that we have a Medicaid-Preservation Plan ready to go before you are ready to disburse.

This article assumes that you have a client, anywhere in Florida, who is interested in learning more about how to keep their Medicaid after settling their car accident, slip and fall, medical malpractice, or any other personal injury claim, and is ready to set up a consultation with us.

Useful Information a Personal Injury Lawyer (or their Client) Can Provide in Advance of their Medicaid Benefits Preservation Consultation

Some people are surprised to learn that "Medicaid" is an umbrella term for more than one type of program. In other words, there are multiple different flavors of Medicaid in Florida: some provide community health insurance to minor children, others require you to be disabled, there are a few different programs specifically for Floridians who have Medicare, and even multiple programs that help pay for home health care aides or long-term care in an ALF or nursing home.

Different rules apply to these different programs.

Knowing which Medicaid program your client is on will result in a more productive Medicaid-planning consultation because we can think through which Medicaid protection strategies to discuss and which are irrelevant.

In addition, I am sometimes able to discuss getting the client on a higher-performing Medicaid program that may entitle them to new and more comprehensive benefits.

How to Determine the Type of Medicaid Benefits a Personal Injury Client is Receiving?

The Department of Children and Families (DCF) has an electronic portal called ACCESS Florida (click the link to see the ACCESS portal login page). If your client has their username and password, its easy to login and look at a summary of programs, which they have been approved to receive (sometimes multiple programs). If they do not have an ACCESS Florida account, the same link will allow them to create one.

Is the Medicaid Recipient also on SSI? 

This can be confusing because both SSI and SSDI are commonly referred to as "disability" (some people say they receive SSI when the really receive SSDI and vice versa... or they say "I'm on disability", which can refer to either program). The differences between SSDI and SSI are discussed at the link. If your client receives ANYTHING from social security, they can access their Benefit Verification Letter (that spells out which Social Security programs they are on) here: SSA Account Portal.

This is important because Floridians on SSI income are automatically entitled to Medicaid Health Insurance benefits. Even getting $1.00 of SSI benefits entitles the income recipient to Full Community Medicaid - and SSI is a needs-based program that can be jeopardized by a personal injury settlement.

In other words, some Medicaid programs come as a package deal with SSI. While, other Medicaid Programs are not contingent on being an SSI recipient.

Another trick to quickly determine whether your client receives SSI or not is to ask how much income they receive each month. If they receive more than $914.00/mo (as of 2023), we know that they are not on SSI -- they instead may be receiving SSDI or Social Security Retirement Income, which are not means-tested programs.

But, if they are receiving SSI, we need to know because we can still protect this benefit, but cannot use the same Medicaid planning strategies as compared to those who receive Medicaid independent of SSI.

What if I Cannot Tell the Type of Florida Medicaid Benefits Received?

The Medicaid Benefits Preservation Consultation can still move forward because I can usually ask some additional questions to at least narrow down which program they are likely receiving. We can then discuss a few different scenarios regarding which Medicaid protection or spenddown strategies can make sense - until we can verify the exact type of benefits at risk.

What Are the Personal Injury Client's Expected Net Proceeds?

One of the most important pieces of useful information to have in advance of the Florida Medicaid Preservation Consultation is the expected net proceeds (after you have deducted your fee and costs that will come from the settlement).

We recognize that, most of the time, you will not be able to provide an exact number (you have medical liens to negotiate, might be waiting for your expert's final bill, perhaps the carrier has given you a range of settlement instead of a precise number, etc...)

But, generally, it would be premature to have a Medicaid Preservation consultation if you don't have a general idea of what your client might receive. The reason is that the strategies that make sense to discuss in an effort to protect $25,000.00 are drastically different than the strategies we might use to protect an injured client who expects to net closer to $250,000.00!

The Personal Injury Settlement Proceeds Medicaid Preservation Consultation

In summary, we are excited to work with personal injury lawyers throughout Florida. The initial consult is subject to a consultation fee (we provide immensely comprehensive information and multiple options, explain their pros and cons, etc...).

By the end of the Medicaid benefits protection consultation, we will be able to quote an exact price. If your client engages our firm, we are happy to do the work on a "LOP" basis and be paid from the injury law firm's trust account when proceeds are ready to be distributed.

The goal is to have everything in place before you are ready to distribute funds so the money can go where the plan dictates, and we can timely report to the government agencies involved.

If ready to schedule an initial consultation please call or email: scheduling@elderneedslaw.com.