Florida Worker's Compensation - Help For Injured Florida Workers

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  1. #1
    Join Date
    May 2007
    Posts
    7

    Default Medicare Set Aside Account

    Im getting ready to settle my 7 yr w/c claim and doesn anyone know how a medicare set aside aside acct will beneifit me in the line of medications?

  2. #2
    Join Date
    May 2007
    Posts
    7

    Default Re: Medicare set aside account?

    I know nothing about the set aside and my attorney hasnt bothered to tell me..does anyone know anything about how they work?

  3. #3
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Medicare set aside account?

    When you buy out your work comp medical benefits or it's included in your work comp settlement the amount is set aside in a trust account. Medicare will kickin when the trust is exhausted.
    For more info see the cms website


    http://www.cms.hhs.gov/WorkersCompAgencyServices/

  4. #4
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: Medicare set aside account?

    Faithhopelove, The medicare set aside is a small portion of your settlement that goes toward furture medical care. Once it is exhausted you will be eligible to use medicare for your health care, provided of course that you have applied for SSDI and are approved. With a WC case onging for 7 years it sounds like a pretty bad injury. Has your attorney not asked for life time medical care through your WC settlement?

    Medicare part D, the drug program, is better than having no medication coverage at all but if you are taking very many expensive drugs it stinks. Once what you have paid and what they have paid totals $2,400.00 you have no drug coverage until you have paid the next $1,450.00 out of pocket. Then they kick in and pay 95% of drug cost for the rest of the year. You would be wise to keep a few thousand of your settlement besides the set aside to meet these future costs as they are recurring every year.

    The only other way I know of to help with cost of medication if you arern't eleigible for state medicaid is the programs that the drug companies offer. Under certain circumstances they will help with the "donut hole" of medicare coverage. Most of them exclude patients if they have any kind of medical/drug coverage including medicare part D however, they also look at it on a case by case basis. Here is one of the web sites that I am referring to,

    http://www.needymeds.com/

    You will need to check each medicaiton that you use as far as which program you might be eligible for.

    Hope this helps you out in some way and good luck on your case.

    Steel

  5. #5
    Join Date
    Feb 2007
    Location
    florida
    Posts
    625

    Default Re: Medicare set aside account?

    The medications should have been taken into consideration when the MSA was completed. You should insist on your attorney sitting down with you and reviewing the document. Any money allocated for the MSA would have to be placed in an account and used for the specific purpose of paying for medical care. Depending on the amount of the settlement CMS approval would be needed. Once the money is exhausted Medicare would then pick up the costs of the medical treatment. They will ask for proof of payments made.

  6. #6
    Join Date
    May 2007
    Posts
    7

    Default Re: Medicare Set Aside Account

    Thank you all for your input..I have since found out alot about the msa and told the atorney that it wasnt eenough to cover my meds so it has been revised. Im ok with it now..just more than ready to get these w/c people out of my life and try to find my life..wherever it went..have you seen it? ha ha
    Ive learned alot..seen alot..and am looking forward to seeing more..there was atime when I couldnt even see getting out of bed ever again..I wanted to die...its been a long hard road and I thank everone who has crossed my path for their faith,hope,and love! Wow..I know I will never be free from the pain..well I will one day..but while Im still on this earth..but to be free from the w/c system thats FREEDOM ENOUGH ..in my book! Thumbs up to the people who can survive this system..our reward will be in heaven for sure!
    And maybe a little here on earth too..yipeeee!
    Thanks yall!

  7. #7
    Join Date
    May 2007
    Posts
    7

    Thumbs up Re: Medicare Set Aside Account

    Thanks..things are moving along..soon I will be through it..its been a long time coming..and its a fine line between sane and insanity in this situation!
    Thanks so much steel for the site..and everyone for your info too.
    Good luck to everyone and much love to all!

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