What is a Medicare Set aside?

A Medicare Set Aside, also known as a MSA, is the amount of money it is estimated will be required to protect Medicare’s interest in the future. This amount is determined by a company who specializes in preparing Medicare Set Aside proposals, typically hired by the workers’ compensation carrier. The company will look at the history of medical treatment you have received, determine what treatment you will need over the course of your lifetime, and determine what that treatment would cost if Medicare paid it. Sometimes, the document will also include any estimates of your future medical needs that Medicare will not cover. If you are a Medicare recipient, approval of the MSA will need to be obtained exclusively from the Centers for Medicare & Medicaid Services, (CMS). If you are not a Medicare recipient, then the amount indicated in the MSA proposal may be relied upon by the parties and the Virginia Workers’ Compensation Commission as the value of your future medical treatment for settlement purposes.

If you are concerned that the value does not adequately cover your future needs, or, if you are concerned that one is required, you should call us to negotiate an appropriate settlement and make sure that all of your rights related to potential Medicare benefits are protected.