Do you have cases that need a Medicare Set-Aside (MSA)? Or maybe a Medical Cost Projection is a better fit? Let’s review what IS and IS NOT in a Medicare Set-Aside.
Medicare Set-Asides cover the basics of medically necessary treatments and prescriptions:
- Medicare Part A Covers: Hospital care, home health care, skilled nursing facility, hospice care.
- Medicare Part B Covers: Medically necessary doctoral services, ambulance services, lab tests, x-rays, durable medical equipment (but not all).
What are you missing that Medicare does not cover?
- Many procedures, treatments, home attendants, prescriptions, and much more.
- A significant amount of these items are not recovered in settlements and can get left behind when plaintiff attorneys typically rely on defense to provide a CMS approved MSA.
- The defense prepares the MSA(s) and prefers the smallest allocation possible for CMS approval. They will not give you what you do not ask for!
How do you find the information? Do you guess at future medicals?
- Without using objective expert support, it could impede your negotiation and cause difficulty with your adversary.
- Some attorneys say they ask for an estimated 35% of past medicals. Is this enough for lifetime care?
For this reason, you may want to consider projections of non-Medicare future care through a Full Medical Cost Projection, which is a tool that evens the playing field between plaintiffs and defendants.
Ryan Weiner, Esq.
MASSIVE: Medical and Subrogation Specialists
MASSIVE is the nation’s leading independent provider of Future Medical Allocation services (including Medicare Set-Asides), and healthcare Lien Resolution.