When you’ve suffered a serious injury, the medical bills don’t stop when your case settles. You might need surgeries years down the line. Physical therapy could continue indefinitely. Medications, assistive devices, home modifications, and ongoing specialist visits all add up.
So how does Louisiana law make sure you’re covered for treatment you’ll need in the future? It’s a combination of proving what you’ll actually require and structuring the money so it’s there when you need it.
Proving Future Medical Needs
You can’t just guess at what treatment will cost later. Courts and insurance companies want documentation. That means getting your doctors to commit to writing about what’s coming.
Life care plans are the gold standard. A qualified professional reviews your medical records, consults with your treating physicians, and creates a detailed roadmap of your future needs. We’re talking about projected surgeries, ongoing therapy sessions, prescription costs, durable medical equipment, home health aides, and anything else your injury makes necessary.
These plans break down costs year by year. They account for inflation in medical costs, which runs higher than general inflation. They also address contingencies. For example, if you’ve got hardware in your spine, there’s a realistic chance you’ll need revision surgery within ten or fifteen years. Medical testimony backs all of this up. Your orthopedic surgeon can explain why you’ll likely need a hip replacement before you turn fifty. Your neurologist can project ongoing medication needs for post-traumatic seizures. Your physical therapist can detail the assistive equipment you’ll require as your condition evolves.
Lump Sum Settlements Vs. Structured Settlements
Once you’ve proven what you need, you’ve got to decide how you’ll receive the money. Louisiana allows both lump-sum and structured settlements, and each has advantages depending on your situation.
A lump sum gives you everything at once. You control the money and can invest it, use it for immediate needs, or set it aside for future care. The risk? If you mismanage it or if costs run higher than projected, you could run out.
Structured settlements spread payments over time. You might get a portion upfront for immediate expenses, then monthly or annual payments for ongoing care. Some structures include larger payments timed to anticipated medical events, like a surgery scheduled for five years out.
The benefits of structuring include:
- Guaranteed income stream that can’t be spent all at once
- Tax advantages since future payments often aren’t taxable
- Protection from your own potential financial mistakes
- Reduced risk that the money runs out before your needs end
The downsides? Less flexibility. You can’t access a lump sum for emergencies. If your needs change dramatically, you’re locked into the payment schedule.
Medicare Set-Asides And Federal Compliance
If you’re on Medicare or will be within 30 months of settling, federal law requires something called a Medicare Set-Aside arrangement. This protects Medicare from having to pay for injury-related treatment that your settlement should cover.
An MSA segregates a portion of your settlement to pay for future medical expenses that Medicare would otherwise cover. You pay out of the MSA first. Once it’s exhausted, Medicare steps in for covered services.
Getting this wrong has consequences. If you don’t properly account for Medicare’s interests and then submit claims for injury-related treatment, Medicare can deny coverage and even seek reimbursement from your settlement funds.
Our Marrero serious injury lawyer team works with MSA administrators to calculate the right amount, document how it’s funded, and make sure you stay compliant with federal reporting requirements.
Louisiana’s Collateral Source Rule
Louisiana follows what’s called the collateral source rule. That means the defendant can’t reduce your damages just because you have health insurance or other benefits that might pay for some of your care.
If your future medical expenses total $500,000, the defendant owes that amount regardless of whether your health insurance will cover part of it. The logic is simple. You paid for that insurance. The wrongdoer shouldn’t benefit from your planning.
There are exceptions and nuances, particularly when dealing with Medicare, Medicaid, or employer-provided benefits that have subrogation rights. But the basic principle protects your full recovery.
Calculating Costs Over A Lifetime
Medical cost projections aren’t static. Inflation matters. So does your age and life expectancy. A twenty-year-old with a spinal cord injury faces sixty-plus years of care needs. A seventy-year-old with the same injury has a different timeline and different total costs.
Economists work with life care planners to present value these future costs. They account for inflation rates, discount rates to reflect present value, and changes in care intensity as you age. The math gets complicated, but it’s necessary to arrive at a fair number.
Protecting Your Settlement
Once you’ve got your settlement, protecting it matters. Special needs trusts can preserve eligibility for means-tested benefits like Medicaid. Professional financial advisors who understand catastrophic injury cases can help structure investments that balance growth with liquidity for medical needs.
At Kiefer & Kiefer, we don’t just get you to a settlement. We work with your medical team, life care planners, and financial professionals to make sure the money you recover actually meets your needs over time. If you’re dealing with injuries that require ongoing care, our Marrero serious injury lawyer team can walk you through how Louisiana law protects your future and what steps we’ll take to document every dollar you’ll need.
