Medicare Set Aside
Your client could lose Medicare benefits if their settlement is meant to pay for injury-related expenses. The experts at Milestone can consult with your client to ensure they do not become disqualified from the program.
Complying with Medicare
Medicare is a secondary payer, which means when an injured person has certain types of insurance coverage or compensation, such as a settlement, other parties are legally responsible for paying first for medical expenses related to the injury before Medicare pays.
Primary payers might include:
- Workers’ compensation
- Settlement from a personal injury lawsuit
- Liability insurance
- Group health plan insurance
- No-fault insurance
If those primary payers do not cover the full cost of services, Medicare may then become responsible for the balance of payment. Beneficiaries risk a denial of coverage for future medical expenses if they do not comply with Medicare’s rules. A Medicare set aside is one way to avoid compromising their coverage.
Consult with Milestone before settlement to determine whether a Medicare set aside is advisable for your client.