If an injured party qualifies for Medicare (must be 65 or older) or will qualify for Medicare within two years, a portion of the settlement must be set aside, separate from other settlement moneys, to pay for future medical bills incurred because of the injury or illness. By law, these Medicare Set-Aside accounts (MSAs) have to pay medical expenses first and be depleted before Medicare will pay for any additional expenses.
Injured parties have a choice. They can manage the MSA account themselves or hire someone to do it for them. The compliance process is complex. The “Self-Administration Toolkit for Workers’ Compensation MSA Arrangements” for example, is 31 pages long. If procedures are not followed properly, Medicare may deny coverage.
The second choice is one that I suggest to clients—professionally managed MSA accounts. For a flat, one-time fee, CareGuard, for example, will administer the injured party’s MSA funds to pay for medical expenses for the life of the MSA. CareGuard coordinates medical care and costs with the injured party’s insurance company and has the ability to negotiate medical and prescription discounts. Just as importantly, it makes sure all MSA government reporting requirements are fulfilled.
Trying to abide by the sometimes confusing MSA rules while recovering from an injury can be an overwhelming experience. That’s why companies such as CareGuard provide a valuable service. CareGuard has recently taken it one step further. It just introduced another program called Amethyst to manage and pay non-MSA medical costs from settlement funds outside MSA accounts.
I would be happy to answer any questions you have about managed MSA accounts. I can also arrange a 1/2 hour meeting with you, a CareGuard representative and myself to go over the process.