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Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Can I spend the Medicare set aside trust?

Are only allowed to spend their MSA funds on Medicare-covered treatments related to their injury. Must report all expenses they used their MSA funds on to CMS each year and in the case their funds run out. Must only pay the state fee schedule or usual and customary pricing for treatments & prescriptions.

Is it illegal to spend Medicare set aside money?

MSA Account Requirements, Rules and Regulations The most important thing you need to know about your Medicare Set-aside Account is that you are not free to spend that money however you want and you are not even free to spend it on every medical need you may have for your injury.

What happens if I spend my Medicare set aside?

Simple answer: When MSA funds are exhausted, Medicare will begin to pay for all covered items related to your injury, only if you have properly managed your MSA funds and reported your spending to Medicare, and if you are enrolled as a beneficiary on Medicare.

Do I need a Medicare set aside?

You will be required to open an WC MSA Account if you are currently eligible for Medicare and your settlement amount is more than $25,000.00 OR if you are not eligible for Medicare and your settlement amount is more than $250,000, but there is a chance you will be eligible for Medicare in the future.

How much does a Medicare Set Aside cost?

Based on current annuity rates, the cost would be approximately $21,000 to fund that payment for the duration of a claimant's life expectancy. Most firms charge a minimum of $500 per year and a maximum of $2,000. Some also include a set-up fee of $2,000.

Is Medicare set aside taxable?

You may pay only the tax amount due on your WC MSA account with WC MSA funds. WC MSA funds themselves are not considered taxable income, but the interest they earn is taxable income.

How long does a Medicare Set Aside take?

How long does it take to obtain CMS approval? As of March 2018, CMS takes anywhere from 30-60 days to review and approve a case. It is important to plan ahead and get the process moving forward if it is determined that a Medicare Set-Aside arrangement is needed.

How does a Medicare set aside work?

A Medicare Set-Aside is a trust or trust-like arrangement that is set up to hold settlement proceeds for future medical expenses. A specialized company evaluates your future medical needs, recommends an amount that should be set aside for future medical care, and the government approves the amount.

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