Illinois Worker's Compensation - Help For Injured Illinois Workers

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  1. #1
    Join Date
    Mar 2011
    Posts
    37

    Default Medicare Set Aside

    My workers compensation claim was made in the State of: Illinois

    Could you explain what a Medicare set aside medical means??? Does it mean that if I were to get a settlement all the funds would go into that and I still would not have enough money to pay outstanding bills ???

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Medicare Set Aside

    the medical benefits portion of a settlement is put in trust to pay for treatment in lieu of medicare payments.
    Medicare has to accept the set aside amount and sign off on the agreement.
    more from the medicare site
    https://www.cms.gov/WorkersCompAgenc...wcsetaside.asp

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Medicare Set Aside

    Could you explain what a Medicare set aside medical means??? Does it mean that if I were to get a settlement all the funds would go into that and I still would not have enough money to pay outstanding bills ???
    Any outstanding bills for medical care should be addressed in any settlement...IF Medicare has paid any conditional payments... those must be reimbursed before your settlement is final... generally, paid by the ER/IC...

    A settlement that includes future medical is an estimate of your potential treatment costs...and a portion if not all the money for FMC you receive would go to a setaside arrangement...it's not a "trust", and MSA is not mandatory by law...but recommended by CMS. The money would go to a interest bearing account, you use it to pay for services Medicare would normally pay for...just as though you were paying out of pocket.

    The only reason for a setaside is because you are/will be Medicare eligible.

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