If you are an injured worker who is on Medicare, you have filed for Social Security, or are otherwise eligible for Medicare benefits, when you settle your workers compensation claim, you and the insurance company have to get approval from Medicare. This often a very lengthy process and many times the entity overseeing the settlement for Medicare will require a self-administered Medicare Set-Aside fund. This means that a portion of the injured worker’s settlement money must be used for future medical care related to the work related injured body part(s). Once those funds have been exhausted, then Medicare will start cover the bills. You will get the funds and need to place the money in an interest bearing account to use for your future workers compensation related medical care that Medicare would have to pay for.
Injured workers who have a Self-Administered Medicare Set-Aside fund need to keep excellent records in order to ensure that they are in compliance with the Self-Administered Medicare Set-Aside fund. The Centers for Medicare and Medicaid has now come up with a tool kit for injured workers which explains this process and breaks down what records and expenses the injured worker needs to keep track of. This is a great tool for anyone who has a Self-Administered Medicare Set-Aside fund stemming from a workers compensation injury settlement. To view the took-kit click on this link.
If you would like more information on the Virginia workers’ compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.