Medicare Set Asides

If you have a workers' compensation claim that is settled either on its own or in conjunction with a third party claim, there may be a need for a Medicare Set Aside to preserve your future eligibility for Medicare benefits. An MSA must be considered if you are Medicare eligible or there is a reasonable expectation to be Medicare eligible within 30 months of the settlement. A Medicare set aside allows you to preserve Medicare benefits by negotiating an allocation of the settlement to Medicare covered expenses and requires those funds to be placed in a segregated account. Once the set aside account is exhausted, you get full Medicare coverage without Medicare ever looking to your remaining settlement dollars to provide for your care.

Since Medicare Set Asides are the only known way to comply with the MSP, it is prudent to consider establish one in liability settlements if you are a Medicare beneficiary. While the law is not clear in liability settlements what is required in terms of a set aside, it is important to make sure the burden is not shifted to Medicare when there is a primary payer.


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