Can I rely on Medicaid or Medicare to pay for my disabled child’s medical needs after a medical mistake?


Painter Law Firm's frequently asked question (FAQ) series

December 6, 2018

The short answer is “no.”

Medicaid and Medicare are government programs that provided limited benefits to eligible individuals.

To receive Medicaid benefits, most people must fall below a certain family income level. Medicaid has some waiver opportunities, though, that apply to disabled children.

Most Medicare beneficiaries, on the other hand, are over 65 years old. However, a baby or child with disabilities who is approved for Social Security Disability Insurance (SSDI) qualifies for Medicare after being on SSDI for over 24 months.

An experienced Texas medical malpractice attorney can help advise you on how to make sure your disabled child receives all the governmental benefits that he or she is eligible to receive.

At Painter Law Firm, we are also careful to preserve Medicaid eligibility—and even the potential for future Medicaid eligibility if our client doesn’t currently meet the income requirements—when structuring a medical malpractice settlement. This can be done by placing settlement funds into a special needs trust, which legally prevents that money from being considered part of the client’s income for the purposes of Medicaid eligibility.

If your child has a severe disability and is approved for SSDI, Medicaid, and Medicare benefits, it’s unlikely that these government programs will cover all the medical needs. Medicare and Medicaid simply don’t have the resources to fund all the therapy, home health assistance, equipment, and treatments that might be needed.

When we file a medical negligence lawsuit on behalf of a client with extensive disabilities, we hire a life care planner to evaluate the client and prepare a life care plan report on the future care that will likely be needed. This evidence is a significant driver in the amount of damages or money that we seek for the client at settlement or trial. Combined with Medicare and Medicaid, these funds help meet the medical and therapy needs of people severely injured by medical mistakes.

Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800, for a free initial consultation.


Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.


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