Medicare Set-Aside Allocation

If your client is a current Medicare beneficiary, or reasonably expected to be eligible for Medicare within 30 months of the settlement date, the Medicare Secondary Payer Act applies, and Medicare's future interest must be considered. The accepted method of consideration is to allocate a portion of the settlement toward future Medicare-covered treatments related to the injury or accident and place those funds in a Medicare Set-Aside account.

Our team of Medicare Set-Aside Certified Consultants produces a comprehensive narrative analysis of the injury and accident, the subsequent treatments, and expected future care.  Included in the analysis is an itemized list of Medicare-covered medical treatments, durable medical equipment, and prescription drugs with the associated costs for the remaining years of the claimant's expected life.  The summation of the expected future Medicare-covered medical expenses is submitted to CMS for review and approval and an MSA account is established.

Many of our certified MSA consultants have worked with or for The Center for Medicare and Medicaid Services, or an affiliated contractor.  When submission of a MSA Allocation is required, our team is well-qualified to prepare the necessary reports and provide the supporting case details to secure a prompt approval without a series of revision and additional document requests.  Our focus is to comply with all CMS guidelines and protect the claimant's future Medicare benefits.

Medicare Set-Aside Allocation:

A financial report that allocates a portion of a settlement to pay for future Medicare-covered medical expenses related to an injury or accident.

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