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

"I just want to thank Synergy for their great work in getting a health insurance lien resolved. The health insurance company refused to reduce their lien a penny from a motorcycle accident involving my client who was not wearing a helmet, a fact that would have hurt our award in front of a jury. Synergy put tremendous pressure on this company, and after months of bombarding this insurance company with statutory requests and threats, they were able to get them to give in and reduce the lien significantly. The cost was minimal in relation to the hard work they put in, and the savings my client received. Client was very happy, and it allowed me to close out a case that I had resolved over 6 months before. Keep them in mind if you are dealing with a smug insurance adjuster who felt confident he would not have to reduce a lien, like I was dealing with. Thank you very much Synergy."

Jeffrey A. Adelman, Esq.
Adelman & Adelman, P.A.

"I just wanted to say thanks to you and the entire Synergy Settlement Services team for helping us put together a series of structured settlements and special needs trusts in two complex cases involving significant recoveries. As always, your accessibility, guidance and expertise on a whole host of post-settlement issues is very much appreciated and valued, particularly with respect to the often confusing topic of Medicare set asides. I look forward to our continued collaboration on cases in the future and am very appreciate of the first rate service your company continues to provide to our clients."

Stephan Le Clainche
Formerly of Babbitt, Johnson, Osborne & Le Clainche

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