Yes - and the mistake that costs people the most money is assuming the settlement check is your money first and everyone else gets paid only if something is left.

Most people think: "I got hurt near a Kaneohe road work zone, I missed work, so the settlement comes to me and my health coverage already did its job."

Hawaii does not work that way. If your care was paid by Medicare, Med-QUEST (Hawaii Medicaid), or some private health plans, they may have a reimbursement claim before you see your net share. In an auto-related injury, Hawaii's no-fault system also matters: the mandatory PIP coverage usually pays the first $10,000 in medical/rehab expenses under HRS Chapter 431:10C. That can reduce what Medicare or your health insurer paid, but it does not erase later reimbursement claims.

The practical difference is how the settlement pie gets divided:

• PIP usually pays first in Hawaii auto cases.
• Medicare can demand repayment for conditional payments tied to the injury.
• Med-QUEST can seek recovery from the injury settlement.
• Private health insurance may demand reimbursement if the plan language allows it, especially employer plans.
• A hospital does not automatically get part of every settlement just because it treated you, but unpaid bills, assignments, or a valid lien can still affect your payout.

For a single parent in Kaneohe, that difference is huge. A settlement that sounds like $40,000 can shrink fast after medical reimbursements, unpaid providers, attorney fees, and case costs. If your injury came from a car or pedestrian crash on Kamehameha Highway during construction season, checking PIP first, then identifying Medicare/Med-QUEST claims early, usually makes the biggest difference in what reaches your household.