Medicare Set Aside Agreements: What Are They and Why Are They Important?

If you or a loved one is receiving medical treatment for a work-related injury or illness, chances are you’ve heard of Medicare Set Aside (MSA) agreements. These agreements are becoming increasingly common in workers’ compensation cases, but many people are still unsure about what they are and what they do.

Simply put, an MSA is a financial arrangement that is designed to protect Medicare’s interests in the event that a person receives a settlement or judgment in a workers’ compensation case. When an injured worker receives a settlement or judgment, Medicare may be responsible for paying for any future medical care related to the injury or illness. By setting aside a portion of the settlement to cover these expenses, the MSA ensures that Medicare funds are not used until the set-aside amount is exhausted.

So why are MSA agreements important? First and foremost, they help to ensure that individuals who have suffered work-related injuries or illnesses receive the medical care they need without incurring significant financial burdens. By setting aside funds to cover future medical expenses, an MSA ensures that injured workers have access to the care they need, even if Medicare is not able to cover all of their medical bills.

In addition to protecting injured workers, MSA agreements also help to protect Medicare itself. Because Medicare is a government-funded program, it is important to ensure that it is not paying for medical expenses that should be covered by other sources. By requiring MSA agreements in certain cases, Medicare is able to ensure that it is not overpaying for medical care.

It is worth noting that MSA agreements are not required in all workers’ compensation cases. They are typically required when the settlement or judgment amount is expected to be above a certain threshold, or when the injured worker is currently receiving Medicare benefits. If you are involved in a workers’ compensation case and are unsure about whether an MSA agreement is required, be sure to check with your attorney or the appropriate regulatory agency.

In summary, Medicare Set Aside agreements are an important tool that helps to protect injured workers and Medicare alike. By setting aside funds to cover future medical expenses related to work-related injuries or illnesses, MSAs ensure that injured workers have access to the care they need, while also protecting Medicare from overpaying for medical care. If you are involved in a workers’ compensation case, it is important to understand the role that MSAs play and to work with your attorney to ensure that your interests are protected.