Do I Have to Repay Medicaid or Medicare After a Personal Injury Settlement?

You’ve received a personal injury settlement — but then you’re told you may owe part of it back to Medicaid or Medicare. What does that mean? Is it true? And if so, how much?

At Ryan & Rouse, we help clients in Alabama understand and resolve medical liens so they keep as much of their settlement as possible. Here’s what you need to know about government reimbursement claims after a personal injury case.

Why Medicaid and Medicare May Be Entitled to Reimbursement

If your accident-related medical bills were paid by Medicare or Medicaid, federal and state law give those programs the right to be reimbursed from your personal injury settlement.

This is called a lien or a statutory right of recovery — and it must be addressed before you receive your full settlement funds.

What's the Difference Between Medicaid and Medicare Recovery?

✅ Medicare (Federal Program)

• Covers people 65+ or with certain disabilities
• Has an automatic right of recovery
• Will require repayment for accident-related care
• The Medicare Secondary Payer Act allows them to claim repayment even before you receive the settlement

✅ Medicaid (State & Federal Program)

• Covers low-income individuals and families
• Each state administers its own lien process
• In Alabama, the Medicaid Agency must be notified of any potential settlement, and they may pursue reimbursement for what was paid on your behalf

How Much Will They Take?

The good news: you won’t lose everything.

• Both Medicare and Medicaid only seek reimbursement for accident-related care — not unrelated treatment
• Skilled attorneys can negotiate lien reductions, especially when:

  • The settlement is small compared to medical expenses

  • The client will need ongoing care

  • There are competing liens or significant attorney’s fees

Our job at Ryan & Rouse is to verify the amount claimed , challenge any unrelated charges , and negotiate a fair resolution.

What Happens If You Don’t Repay?

Failing to resolve these liens can result in:

• Delays in receiving your settlement
• Legal action from the government
• In Medicare cases, your future benefits may be affected

Our firm always checks for Medicare and Medicaid liens before disbursing any settlement funds — and we work to get them resolved as efficiently and affordably as possible.

Let Ryan & Rouse Handle the Heavy Lifting

When you’re recovering from an injury, the last thing you should worry about is dealing with government agencies or unexpected repayment demands. At Ryan & Rouse, we don’t just fight for your settlement — we fight to maximize what you keep.

📞 Call us at (256) 801-1000 for a free consultation. We’ll protect your rights, negotiate your liens, and help you move forward with peace of mind.