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

“Synergy Lien Resolution Services just finished getting an ERISA lien dramatically reduced for me. I tried for months, asked for the plan etc., tried to understand it, to little avail. Synergy got it slashed way beyond what the carrier told me that they would ever agree to. It cost my client peanuts, benefited her huge. I won’t ever screw around with trying to get those reduced; from now on they all go to Synergy.”

Rick Kolodinsky
Rick Kolodinsky, P.A.

"Coincidentally, on the day of a recent Synergy Seminar on Medicare & ERISA lien resolution I received a letter on an ERISA lien. This letter followed much back and forth between myself and the recovery vendor for BCBS. Despite my efforts they were adamant there would be no (zero)(zilch)(nada) reduction and provided case law to support their position. I tried Synergy’s Lien Resolution Services since I had just heard their Director of Lien Resolution speak. Synergy got them to reduce their claim by a third in less than ten (10) days. The result was quick and the fee very reasonable. If you have a tough ERISA lien and your typical efforts don’t work, give Synergy a try."

Michael S. Smith, Esq.
Lesser, Lesser, Landy & Smith, PLLC

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