Do I Need a MSA?

Injured individuals who are already Medicare beneficiaries must always consider Medicare's interest prior to settling their workers comp or liability claim regardless of whether or not the total settlement amount exceeds $250,000. That is, ALL BENEFIT PAYMENTS regardless of amount must be considered for current Medicare beneficiaries.

What is a Medicare Set-Aside Arrangement?

A Medicare Set-Aside Arrangement is the method designated by the Centers for Medicare/Medicaid Services (CMS) to comply with the Medicare Secondary Payer Statute (MSP) 42 U.S.C §1395y(b)(2) and § 1862(b)(2)(A)(ii) of the Social Security Act, which dictates that Medicare is precluded from paying for a beneficiary's medical expenses when payment has been made or can reasonably be expected to be made under a workers' compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan), or under no-fault insurance.

A Medicare Set-Aside Arrangement is a monetary fund created at the time of a workers compensation or other liability case settlement where future medical is being finalized. The monetary funds are placed in a separate interest bearing account in order to pay for medical expenses related to the job injury or illness that would otherwise have been paid by Medicare.

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