Can Medicare Take My Entire Personal Injury Recovery Settlement?

If you suffered an injury in an accident and Medicare covers your related medical bills, you may be worried about Medicare taking your personal injury settlement or judgment. But while Medicare may take some of your settlement, it generally will not take the entirety of your recovery. 

An attorney at our firm can help you navigate the process of pursuing compensation in a personal injury case and handling any requests for reimbursement from Medicare or other parties. 

What Is a Medicare Lien?

Often referred to as a Medicare “lien,” a Medicare recovery claim is a demand made by Medicare to recover its costs that another party should have covered. If Medicare paid your medical bills after an accident, the agency may have a recovery claim against your eventual settlement or judgment. 

Medicare’s Procedure for Personal Injury Payments

The Medicare Secondary Payer program exists so that the agency is aware of cases where other parties may be liable for its beneficiaries’ medical payments. So, Medicare requires reporting such cases to the Benefits Coordination and Recovery Center (BCRC).

If you were in a car accident in Houston and another party caused the wreck, then you would likely file a claim against their liability coverage. The at-fault driver’s liability coverage is responsible for your medical bills. However, if Medicare covered your medical bills before the car insurer paid the bills, then Medicare may seek reimbursement. 

Medicare would require you to report the accident and insurance claim to the BCRC so it can seek reimbursement. D. Miller & Associates, PLLC™ can assist clients with this process and manage their case from start to finish. 

Medicare’s Rights to a Personal Injury Settlement

Medicare has a right to seek reimbursement for payments it makes to medical providers that should be covered by other parties, such as liability insurance policies. But Medicare considers any costs associated with procuring a settlement or judgment when calculating how much to recover. 

For example, suppose Medicare’s expenses equaled or exceeded the value of a settlement or judgment. In that case, it generally will not take the entirety of the recovery, accounting for costs associated with procuring the recovery. 

The exact amount that Medicare will seek to recover depends on several factors, such as the medical bills incurred and the value of the recovery. Medicare will inform you about how much it spent on your medical expenses. Work with an attorney to better understand how Medicare liens might affect your case and recovery.

Appealing Medicare’s Reimbursement Demand

If you disagree with the reimbursement amount in Medicare’s demand letter, you have 120 days to appeal. Your appeal needs to include documentation supporting your appeal.

Recoverable Damages in a Personal Injury Case

Part of ensuring you receive adequate compensation for your injury is accounting for all your short- and long-term losses. Some examples of economic and noneconomic damages that you may recover include:

  • Medical expenses incurred
  • Ongoing and long-term medical expenses
  • Physical therapy costs
  • Lost wages and reduced future earning capacity
  • Pain and suffering
  • Mental anguish

Before accepting an insurance company settlement offer, speak with a lawyer at our firm. We can review the offer and negotiate a fair settlement covering all losses. We will also help you navigate requests for reimbursement from Medicare and other parties. 

How Our Attorneys Help You Pursue the Settlement You Deserve

Our injury lawyers represent you from start to finish, meaning we will help you file your claims, pursue compensation, and communicate with all parties, including Medicare or others seeking reimbursement from your settlement.

Here are some of the ways we can help you:

  • File paperwork and meet deadlines that apply to your case
  • Review medical bills, including those covered by Medicare, to seek full compensation for medical expenses
  • Identify other damages, including lost wages and pain and suffering 
  • Negotiate for a fair settlement or represent you at trial, if needed
  • Review Medicare demand letters and help navigate the reimbursement process
  • Keep you updated on the status of your case from beginning to end
  • Answer your questions and provide support for the duration of your case

Let Us Handle Your Personal Injury Case

Darren A. Miller founded D. Miller & Associates, PLLC™ in 2002, and we have been helping clients pursue compensation for their injuries ever since. We help people in Houston following car accidents, truck accidents, slips and falls, motorcycle accidents, and more.

Call us today for a free case review and hire a team for your Houston personal injury case.