MSA – Medicare Set-Aside

Medicare can be a complicated process for both clients and their attorneys. If not handled properly, negligence traps will abound for all parties. If you are representing a Medicare beneficiary that has won a settlement, you need to ensure that your clients’ Medicare benefits are preserved. Preserving their benefits is a process that will require a thorough understanding of the laws that govern Medicare.

What is Medicare Set-Aside and When is it Necessary?

Medicare is a federal health insurance program that is available to individuals without regard to their financial situation. Individuals who are 65 years or older, have certain medical conditions or have a permanent qualifying disability are entitled to these benefits.

Medicare MSA is ideal for clients with a settled workers’ compensation or third party liability claim who may need to preserve their future Medicare benefits. However, they must be a current Medicare beneficiary or a Medicare expected beneficiary within 30 months of their settlement.

An MSA allows injury victims to preserve their Medicare benefits by setting aside a portion of their settlement money into a Medicare-approved account to pay for future Medicare covered services. Once these account funds are exhausted, the individual is entitled to full Medicare coverage without regard to their remaining settlement money.

What is a Medicare Set-Aside Allocation?

An MSA allocation is an in-depth review and accurate projection of the lifetime future medical costs associated with an injury that is anticipated to be covered by Medicare. Those projected costs are then “set side” from the “allocation” for future medical in an effort to protect Medicare’s interest.

Services We Offer Trial Attorneys

We have been helping trial attorneys and their clients with their MSA and settlement planning needs for over 25 years. We assist trial attorneys across the nation with the following MSA services:

  • Medicare Set Aside Allocations
  • MSA Professional Administration
  • MSA Analysis
  • Liability Case Evaluation
  • Non-Medicare Expense Evaluations
  • Future Medical Projections
  • Case Review
  • MSA Submissions
  • Economic Evaluation
  • Mediation Attendance
  • Structured Settlements
  • Documentation Prep
  • CLE Training

Partner With a Premier Provider

Partnering with Synergy Settlement Solutions makes the entire MSA process and compliance with Medicare Secondary Payer (MSP) so much more efficient and inexpensive. Involving Synergy early in the process is critical to your client’s success. Let us help you streamline the MSA process and save your clients thousands of dollars on individual claims.

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 recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

I wanted to pass my highest recommendation to Synergy who we routinely get involved in cases when Medicare issues come up, especially when dealing with Medicare Set Asides. Synergy went beyond the call of duty in a recent case that was settled and dealt one-on-one with our clients and their family. They spent time on the phone with them to be sure they got all their questions answered and did a fantastic job dealing with Medicare.

J. Daniel Clark
Clark Martino, P.A.

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