Medicare Set Aside Personal Injury

Is Your Client a Medicare Beneficiary?

When an injury settlement is won, the hope is that the money will continue to cover the injured person’s medical needs, but sometimes the settlement money runs out. If your client is a Medicare beneficiary, it is important that they remain in compliance with Medicare regulations. If they aren’t compliant, their Medicare eligibility can be jeopardized and you can also become legally liable.

What Does Medicare Have to Do With a Client’s Settlement?

If your client wins a settlement for workers compensation or some other third-party settlement, Medicare must be considered because, by law, the insurance/settlement is considered the primary payer. According to federal law, the burden of injury-related medical expenses cannot be shifted to Medicare where future medical expenses are concerned. In this case, Medicare is considered the secondary payer.

Medicare Set Aside Workers Compensation

Therefore, it is critical that a client’s Medicare benefits be secured by establishing a Medicare Set Aside (MSA) account. With a medicare set aside personal injury account, a portion of your client’s settlement is placed into a segregated account to pay for injury-related medical expenses (usually covered by Medicare) until it is exhausted. Once these funds are exhausted, Medicare will begin paying for the injury-related expenses. Detailed recordkeeping and reporting to the Centers for Medicare and Medicaid Services is critical.

Why You Need Synergy Settlement Solutions

There are a lot of rules and regulations governing Medicare, especially where a personal injury settlement is concerned. It is likely that both you and your client may have questions about how to set up medicare set aside workers compensation properly. Let us put your concerns to rest.

Our group has over 25 years of experience assisting attorneys and their clients with MSA related services. We manage the recordkeeping and reporting requirements for medicare set aside personal injury clients to ensure they remain in compliance in order to maintain future eligibility for injury-related Medicare benefits. We can help you determine if your client needs an MSA account or the allocation amount, as well as answer questions about funding and administering the account.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

TESTIMONIALS

"In my twenty-two year career as a trial lawyer I've handled my share of catastrophic cases and structures, but imagine the complexity of an engaged, unwed mother catastrophically injured during delivery, giving birth to a healthy child, but left in a vegetative state? The issues of guardianship and entitlements of the newborn, the rights of the biological father-fiancé, an out-of-state teenage child of the mother, lifetime maintenance of the mother, as well as the rights of family of the mother, who became her primary care-takers? Synergy systematically managed the seven figure tender of one defendant, the establishment of a Qualified Settlement Fund, a Special Needs Trust, and multiple structures, all the while concurrently maintaining the various entitlements to ancillary services, as well as the remaining litigation. Everything was handled professionally, timely and literally without a hitch. Truly an amazing feat."

Marcus J. Michles II
Michles & Booth

"We have been using the lien resolution services Synergy offers for over a year, and it has been a load off of our back. As a trial attorney, I need my staff to spend time on litigation, not waste their time on hold with Medicare. The time and effort that we used to spend resolving issues with Medicare is now being used in much more productive ways. I haven’t called Medicare in over a year, and I hope I don’t have to call them again."

John D. Ayers, Esq.
Marks & Harrison, P.C.

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