I receive SSI and am about to receive a pain and suffering insurance settlement. How can I maintain my medicaid benefits.

The question is "how much are you netting from the settlement?" You should discuss this with your PI attorney.  if the amount is large, then you may wish to consider a Special Needs trust.  This shelters your money, but if there is money still in the trust when you die, the State may be able to sieze the funds. If the amount is small, then if the funds are paid to you early in the month, then you may be able to spend them down fast enough to preserve your SSI and Medicaid. These are issues that a good PI attorney can address with you.  My guess is that Mediaid may have paid some or all of your bills for the accident, so your attorney is already dealing with the Medicaid statutory lien.  This is all part and parcel of the same "can of worms," Make an appointment to meet with your PI attorney and do not sign the final settlement papers until these issues are resolved.