A Medicare Set Aside is a calculation of injury related future medical treatment that would otherwise be covered by Medicare. Typically an MSA is determined for settlement purposes in a workers' compensation or liability settlement.
Read more about Medicare Set Aside.
If a settlement is reached in a personal injury involving a Medicare beneficiary, Medicare will need to be placed on notice of the settlement and any payments that Medicare has paid for injury related treatment would need to be reimbursed. It would also need to be determined if a Medicare Set Aside would need to be included in the settlement.
Read more about Settlement Services.
Estimating future costs of your injury related future treatment and future earnings loss is part of the settlement process. Some settlements will require a Medicare Set Aside or Future Medical cost to be calculated based on treatment patterns, physician recommendations and evidence based medicine guidelines.
Read more about Medical Cost Projections.
A Workers' Compensation Medicare Set Aside is a calculation of injury related future medical treatment that would otherwise be covered by Medicare. Typically an MSA is determined for settlement purposes in a workers' compensation settlement. A portion of the settlement funds are set aside for the Medicare Set Aside and are used to pay for treatment that would otherwise be paid for by Medicare and is related to the injury covered in the settlement.
Once Medicare has been notified of a workers' compensation, liability or no-fault settlement, judgment, award or other payment, Medicare will review the payments made for medical treatment and determine which payments were for the injury released in the settlement. The payments are listed in a conditional payment letter and sent to the appropriate party (debtor) for reimbursement. This is called the demand letter. The assigned debtor has a specific timeframe noted in the demand letter to reimburse Medicare for the payments. If payment is not made, Medicare will start to accrue interest and may send the demand to collections with the U.S. Treasury office.
The Medicare set aside account, is the bank account the funds for the Medicare Set Aside are deposited in. The MSA account should pay for any medical expenses that would otherwise be covered by Medicare and are related to the injury resolved in a workers' compensation or liability settlement. The account will need earn interest and keep track of expenses for Medicare reporting purposes.
A workers' compensation claim is a claim made for wage replacement and medical treatment for injury sustained in the course of employment.
MSP means Medicare Secondary Payer. Insurers should understand that Medicare is secondary once ongoing responsibility for medical or a settlement, judgement or award has been issued.
A special needs trust is used to set aside money for future care for a individual with a disability. The special needs trust will protect the disabled individual's Social Security benefits and Medicaid benefits.