What is Needed to Submit a Medicare Set Aside?

Your client has a responsibility to ensure that Medicare’s interests as a secondary payer are protected. And since they are your client, the responsibility extends to you as well. Medicare has strict rules in regards to payment for current and future medical expenses. If those rules, are not adhered to, your client may be forced to pay a large portion of their settlement to repay Medicare or lose their right to future Medicare benefits. Either result could expose you to a malpractice claim. The recommended way to alleviate this potential pitfall is by establishing a Medicare set aside (MSA).

About Medicare Set Asides

A Medicare set aside is an arrangement in which money is taken from your client’s settlement and “set aside” to cover the costs of future medical expenses. It’s important to note that money in an MSA is only to be used for expenses related to the specific injury in which the settlement is related. While you or your client can establish an MSA yourself, due it’s complicated nature and importance, it’s a good idea to contact Synergy Settlement Services, a company that specializes in Medicare set aside administration.

What Do You Need to Establish an MSA?

If you do choose to establish and administer an MSA, there are several items that you will need. These include:

  • No less than two years worth of records of treatment related to the injury.
  • Payment records for that timeframe.
  • Your client’s prescription history
  • A Medicare Set Aside Evaluation Referral form

If you are submitting the MSA to the Centers for Medicare and Medicaid Services (CMS), expect about 30 days for them to return an evaluation. A CMS evaluation, while not required, can be helpful in determining if your MSA allots enough money to cover future medical expenses.

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 provides great service and are very helpful to my clients. Sometimes clients have trouble understanding the annuity concepts and Synergy does a wonderful job making everything clear and understandable. It is a pleasure to work with Synergy on cases."

Glen Wieland
Wieland, Hilado & Delattre

"Synergy is an invaluable partner in the mediation process. They have extensive expertise in Medicare, Medicaid and Structured Settlements and the ability to explain the impact of these complex concepts to my clients in simple, clear and understandable language. This allows me to focus on obtaining the best possible result in the settlement process."

Michael J. Winer, Esq.
President Florida Workers Advocates (FWA)

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