How Can I Help My Client Preserve Their Medicare Benefits?

You’ve fought on behalf of your wrongfully-injured client and won them the settlement they need. However, they are also Medicare beneficiaries and neither of you wants to see them lose out on those benefits. Fortunately, there are actions you can take, such as seeking out a Medicare set-aside professional. Read on and reach out to MSA Meds to learn more about how you can help your clients preserve their Medicare benefits even after receiving a workers’ compensation or personal injury settlement. Here are some of the questions you may have:

How can an injured worker or plaintiff preserve their Medicare benefits?

The Centers for Medicare/Medicaid Services (CMS) has set forth Medicare Set-Asides (MSAs) as the tool to protect Medicare’s interests and thereby preserve your client’s future entitlement to Medicare benefits. MSAs should be considered for settlements involving injuries covered under workers’ compensation plans, no-fault insurance, automobile insurance plans, certain structured settlement annuities, and certain group health plans.

What happens if my client’s Medicare set-aside runs out of funds?

If your client’s Medicare set-aside has been properly allocated and has nonetheless run out of funds, as long as your client has exhausted those funds properly and in accordance with CMS guidelines, Medicare will begin paying your client’s medical expenses going forward. That said, your client will still be responsible for co-pays for services and medications. That is why it is important to make sure the MSA was properly allocated.

What steps must my client take to ensure that Medicare will pay bills after the MSA funds run out?

To protect their future Medicare entitlement for injury-related care, your clients must follow all of CMS’s guidelines for proper administration of their MSA Accounts. For example, your client will be required to hold all MSA funds in an interest-bearing account, use these funds exclusively for treatment for the specific injury, pay for only expenses that would otherwise be paid by Medicare and in accordance with the Medicare-approved fee schedule, keep detailed records of all payments, and prepare and file annual accounting reports with Medicare.

MSA Meds understand these tasks may be too complicated for clients to handle on their own. Our free professional administration program is here to help them get the treatment they need while at the same time protect their future Medicare benefits. If you have any further questions about how Medicare set-asides function, or you’d like an experienced team in your corner, please don’t hesitate to contact MSA Meds today.