How a Personal Injury Settlement Affects Medicaid in Washington DC

If you receive Medicaid in Washington DC and are pursuing a personal injury claim, you may be asking:
“Will my personal injury settlement affect my Medicaid eligibility?”
The answer is yes—but with the right legal tools and guidance, you can protect your benefits.

This guide explains how a personal injury settlement impacts Medicaid in Washington DC, and what steps you can take to safeguard your healthcare coverage and compensation.

Medicaid Eligibility Rules in Washington DC for Injury Settlement Recipients

To qualify for Medicaid in Washington DC, applicants must meet income and asset limits. A personal injury settlement may increase your countable resources and disqualify you if not handled correctly.

Financial Limits That Affect Medicaid Eligibility in DC

• Asset limit: $2,000 for individuals (excluding exempt assets like your home and one vehicle)
• Income threshold: Varies by household size and eligibility group

A personal injury settlement may push you over these limits unless your funds are managed properly.

How a Personal Injury Settlement Impacts Medicaid Eligibility in Washington DC

A personal injury settlement is considered income or a resource by Medicaid—even if you only receive a portion after legal fees.

Why Medicaid Counts Injury Settlements as a Resource

• The settlement increases your available assets
• Even unused funds count in the month received
• Medicaid can disqualify you for exceeding asset limits

Knowing this ahead of time allows you to make informed legal decisions to protect your eligibility.

Structured Settlements vs. Lump-Sum Payments in Medicaid Cases

Your settlement structure plays a key role in whether you stay under Medicaid’s limits in DC.

Lump-Sum Injury Settlements and Medicaid Disqualification

A one-time lump-sum payment is fully countable as a resource in the month received and can lead to immediate Medicaid disqualification in Washington DC.

How a Structured Settlement Can Help You Keep Medicaid in Washington DC

A structured personal injury settlement pays you in installments over time. If set up properly, it can help you avoid breaching the Medicaid income or asset threshold.

To protect your benefits, structured settlements must be legally tailored to comply with Medicaid’s rules.

Legal Strategies to Protect Medicaid After a Personal Injury Settlement in Washington DC

To avoid losing Medicaid coverage, your settlement must be shielded using appropriate legal tools.

Special Needs Trusts to Protect Medicaid Benefits in Washington DC

A Special Needs Trust (SNT) lets you move your settlement funds into a legally protected trust that does not count against Medicaid eligibility.

Approved trust expenses include:

• Healthcare and therapies not covered by Medicaid
• Housing, transportation, and utilities
• Assistive devices and caregiver services

Medicaid Set-Aside Accounts in Washington DC Injury Settlement Cases

Though less commonly used than SNTs, a Medicaid Set-Aside Account may reserve a portion of your settlement for future medical costs, ensuring Medicaid won’t be responsible for those services.

Reporting a Personal Injury Settlement to DC Medicaid

Under DC law, you must report your personal injury settlement to Medicaid within 10 days of receiving it.

How to Report Your Settlement to Medicaid in Washington DC

• Notify the DC Department of Health Care Finance in writing
• Submit settlement documents
• Provide trust or account documentation (if applicable)
• Disclose how you plan to use the funds

Visit dhcf.dc.gov for official guidance.

Failure to report can result in loss of coverage or legal penalties.

Medicaid Liens on Personal Injury Settlements in Washington DC

If Medicaid paid for treatment related to your injury, they may file a lien against your personal injury settlement to recover those costs.

How a Lawyer Can Help with Medicaid Liens in DC

• Verify lien validity and amount
• Negotiate a lower repayment
• Ensure compliance with Medicaid lien law
• Coordinate disbursement with the settlement

Ignoring a Medicaid lien can delay your payment and endanger your coverage.

Why You Need a Lawyer for Personal Injury Settlement and Medicaid Protection in Washington DC

A lawyer who understands both personal injury law and Medicaid regulations in DC is essential to protect your rights and benefits.

What a Medicaid-Savvy Injury Lawyer Will Do for You

• Set up a Special Needs Trust or structured settlement
• Help report your settlement properly
• Handle Medicaid lien negotiations
• Keep your benefits safe and intact

Get Help with Your Personal Injury Settlement and Medicaid Protection Today

At Roeser Law Firm PLLC, we help Washington DC residents recover compensation while maintaining their Medicaid eligibility. Whether you’re facing a large personal injury settlement or just beginning your case, we guide you through every step.

Don’t risk losing your essential healthcare coverage.

Call us today at (202) 660-4070 or contact us online to schedule a free consultation.