Do I Have to Pay Back Medicare After an Accident Settlement?

Why Does Medicare Require Reimbursement?

Under the Social Security Act, Medicare is considered a “secondary payer.” That means Medicare is not responsible for covering medical expenses when another source, such as workers’ compensation, automobile insurance, liability insurance, or no-fault insurance, is available to pay.

To protect this rule, the law gives Medicare subrogation rights, allowing the government to step into your shoes to recover payments it has already made. Specifically, federal law states:

“The United States shall be subrogated (to the extent of payment made under this subchapter for such an item or service) to any right under this subsection of an individual or any other entity to payment concerning such item or service under a primary plan.”
(42 U.S.C. § 1395y(b)(2)(B)(iv))

What Is a Medicare Medical Lien?

When Medicare has paid for your accident-related treatment, it enforces its right to reimbursement through a Medicare lien. Here’s what that means:

• A lien is placed on your personal injury settlement or judgment.
• Before you (or your attorney) can distribute the settlement funds, Medicare must be repaid.
• In some cases, the repayment amount may be reduced through negotiation or hardship considerations, but Medicare generally gets priority over other expenses.

Why This Matters for Your Case

Failing to address a Medicare lien can delay your settlement, reduce your net recovery, and even create ongoing legal issues. Because the rules are complex and the government is aggressive in enforcing them, having an experienced attorney handle this process is essential.

How Simon Law Group Can Help

At Simon Law Group, we regularly assist clients in navigating Medicare lien issues during personal injury cases. Our team ensures that:

• All liens are identified and verified early in your case.
• Negotiations with Medicare are handled properly.
• You receive the maximum possible recovery after all obligations are met.

📞 Contact Simon Law Group LLC today 800-709-1131 or text us at 908-864-4450 to discuss your personal injury claim and learn how Medicare liens may affect your case.