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  1. #21
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Self Administrate MSA

    If I hired Medivest to administrate my MSA and they charged $10000 a year for there services, that would be a extra $280000 lifetime expense. A settlement would never happen.
    I never said it would be 10K per year... I said there could be set up fees for the accounts where a professional administrator handled the MSA. It would be rediculous to think 10K per year would be paid by anyone.

    No...I dont have an MSA... I have a CMS review and approval letter outlining the WCMSA submitted. I have the annuities in place, and reams of paperwork I have compiled so I can make an intelligent decision before I accept a WCMSA. You don't need to HAVE a MSA in place paying the bills to have even a reasonable grasp of the requirements and mandates of what is included in self administration.

    .3 Do you have a Custodial Account and if you do what have you used it for?
    How many times does a 'custodial account' have to be defined...? you use this money for ALL treatment/services the Medicare precludes use of the MSA funds for. Particularly where the MSA is funded by an annuity, you run a higher risk of exhausting those funds before the next deposit is made. When that happens, YOU pay out of pocket for the share of cost regular Medicare does not cover. In some cases that could be a significant amount of money.
    I may understand if a person had a very serious medical condition requiring lots of medical attention and needs but there are many cases like mine where a person just sees a doctor once a month
    Sorry...that is NOT the case... if it were... do you actually think Medicare would give a shit how the bills were paid for your injury...?
    It is not a simple as you think... I'm happy for you in your situation that everything is taken care if as it is. It would not be fair to others contemplating a WCMSA to see things as simple as you do.

    I feel these are "fair" questions. These are life changing decisions we are having to choose/settle/make etc.
    You're absolutely right...these are life altering issues. Sometimes the way questions are asked, and asked again but with a little 'twist' I have to wonder just how much reading is done at the links provided. There is a LOT of information out there regarding WCMSAs' and custodial accounts...if they weren';t necessary... that wouldn't be the case.
    I don't have all the answers...no one has or there woudn't be other blogs and seminars that discuss these issues all the time. No MSA is cut and dried. It's not fair to other IW's to say they are.

  2. #22
    Join Date
    Apr 2007
    Posts
    183

    Default Re: Self Administrate MSA

    My MSA is funded by an annuity also. Do you mean that if for some reason I run out of money before my next payment Medicare will not cover any "Injury related" medical expenses?. I would not do anything that was not medicare approved to begin with as stated in the Medicare & You book 2009. If you follow the medicare guidelines and use only medicare approved treatments and drugs I thought they would be covered by medicare even if you ran out of funds before your next payment.

  3. #23
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Self Administrate MSA

    Do you mean that if for some reason I run out of money before my next payment Medicare will not cover any "Injury related" medical expenses?.
    Where did you see that...?
    IF you run out of MSA money before the next annual deposit, you bill Medicare...Medicare pays the bills, but you pay the co pays/deductibe out of your pocket..when the money is deposited again...you reimburse Medicare for any conditional paymenst they have made... which in turn obviously reduces the amount for that year... providing the possibility of early depletion for the next few years as well... depends on the individul situation... Which means... you NEED the custodial account money to cover those possibilities. All MSA's are based on ''IF's''...

    Also, the custodial account money is a PLUS to you...it's not accountable to Medicare... and can be used for ANY treatment/DME or other items you wish. Even CMS/Medicare recommends custodial money.

    I would not do anything that was not medicare approved to begin with as stated in the Medicare & You book 2009.
    It's a good thing you have the booklet..but thats' what it is...a 'booklet', it does NOT cover all the little nuances of Medicare program. There are 1000's of codes used in medicine to cover and identify EVERYTHING medicine related... Medicare tags your SSN that a MSA is in place, and all the codes are prefaced with a 'W" basically... depending on the service and billing code... Medicare will accept/deny as the case may be. That is part of 'bill review'... which is the administrators responsibility.

  4. #24
    Join Date
    May 2007
    Posts
    408

    Default Re: Self Administrate MSA

    Quote Quoting BvIA View Post
    I never said it would be 10K per year... I said there could be set up fees for the accounts where a professional administrator handled the MSA. It would be rediculous to think 10K per year would be paid by anyone.

    No...I dont have an MSA... I have a CMS review and approval letter outlining the WCMSA submitted. I have the annuities in place, and reams of paperwork I have compiled so I can make an intelligent decision before I accept a WCMSA. You don't need to HAVE a MSA in place paying the bills to have even a reasonable grasp of the requirements and mandates of what is included in self administration.

    How many times does a 'custodial account' have to be defined...? you use this money for ALL treatment/services the Medicare precludes use of the MSA funds for. Particularly where the MSA is funded by an annuity, you run a higher risk of exhausting those funds before the next deposit is made. When that happens, YOU pay out of pocket for the share of cost regular Medicare does not cover. In some cases that could be a significant amount of money.
    Sorry...that is NOT the case... if it were... do you actually think Medicare would give a shit how the bills were paid for your injury...?
    It is not a simple as you think... I'm happy for you in your situation that everything is taken care if as it is. It would not be fair to others contemplating a WCMSA to see things as simple as you do.

    You're absolutely right...these are life altering issues. Sometimes the way questions are asked, and asked again but with a little 'twist' I have to wonder just how much reading is done at the links provided. There is a LOT of information out there regarding WCMSAs' and custodial accounts...if they weren';t necessary... that wouldn't be the case.
    I don't have all the answers...no one has or there woudn't be other blogs and seminars that discuss these issues all the time. No MSA is cut and dried. It's not fair to other IW's to say they are.



    I understand the definition of a Custodial Account . I ask you if YOU had a Custodial Account and what YOU had used it for.

    My intelligence on MSA is above the average IW. I have spent many hours reading information about MSA accounts, funding of MSA accounts, and settling with WC. Most IW do not have a MSA to worry with. Each IW MSA needs are unique ALL IW are aware of this. Sometimes I wonder if you know this since your answers are always the same. The last part of this thread has been between you, MAW and self. There is no reason to spin the thread as if you were addressing IWs as a whole.

    My MSA account is what I now have to focus on. A Custodial Account will not be included in my settlement. So there is no need for me to focus on something the IC would not approve Same for administrative assistance on the MSA.

    Hopefully, my MSA will be funded without using Medicare for many years. If I run out of money, I will have out of pocket expenses. I understand this.

    [QUOTE=BvIA;119553]Where did you see that...?
    IF you run out of MSA money before the next annual deposit, you bill Medicare...Medicare pays the bills, but you pay the co pays/deductibe out of your pocket..when the money is deposited again...you reimburse Medicare for any conditional paymenst they have made... which in turn obviously reduces the amount for that year... providing the possibility of early depletion for the next few years as well... depends on the individul situation... Which means... you NEED the custodial account money to cover those possibilities. All MSA's are based on ''IF's''...

    Conditional payment on what?

    Conditional payments are usually discussed along with WCMSAs, but in reality conditional payments have nothing to do with WCMSAs. A conditional payment is any payment that the Centers for Medicare & Medicare Services (CMS) has improperly paid on behalf of a Medicare beneficiary. The payment is made by CMS on the "conditional that" CMS will be paid back at the time of settlement.

    http://www.wcmsainfo.com/conditional_paymentshtml.html

  5. #25
    Join Date
    Apr 2007
    Posts
    183

    Default Re: Self Administrate MSA

    [QUOTE=smackman;119571]I understand the definition of a Custodial Account . I ask you if YOU had a Custodial Account and what YOU had used it for.

    My intelligence on MSA is above the average IW. I have spent many hours reading information about MSA accounts, funding of MSA accounts, and settling with WC. Most IW do not have a MSA to worry with. Each IW MSA needs are unique ALL IW are aware of this. Sometimes I wonder if you know this since your answers are always the same. The last part of this thread has been between you, MAW and self. There is no reason to spin the thread as if you were addressing IWs as a whole.

    My MSA account is what I now have to focus on. A Custodial Account will not be included in my settlement. So there is no need for me to focus on something the IC would not approve Same for administrative assistance on the MSA.

    Hopefully, my MSA will be funded without using Medicare for many years. If I run out of money, I will have out of pocket expenses. I understand this.

    Quote Quoting BvIA View Post
    Where did you see that...?
    IF you run out of MSA money before the next annual deposit, you bill Medicare...Medicare pays the bills, but you pay the co pays/deductibe out of your pocket..when the money is deposited again...you reimburse Medicare for any conditional paymenst they have made... which in turn obviously reduces the amount for that year... providing the possibility of early depletion for the next few years as well... depends on the individul situation... Which means... you NEED the custodial account money to cover those possibilities. All MSA's are based on ''IF's''...

    Conditional payment on what?

    Conditional payments are usually discussed along with WCMSAs, but in reality conditional payments have nothing to do with WCMSAs. A conditional payment is any payment that the Centers for Medicare & Medicare Services (CMS) has improperly paid on behalf of a Medicare beneficiary. The payment is made by CMS on the "conditional that" CMS will be paid back at the time of settlement.

    http://www.wcmsainfo.com/conditional_paymentshtml.html
    Yes, What Conditional payments are you talking about??? I also don't have a custodial account. If you are in the process of having a MSA approved are you going to use a professional administrator to handle your account? Are you going to have a custodial account? Who sets up a custodial account and how much money does it cost to set one up and maintain it? Why do you really need a custodial account? Unless you are very poor at keeping records and not very good at keeping your investments in order and not touching your MSA account for any purpose that it was not intended to be used for I don't see why you would need a custodial account.

  6. #26
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Self Administrate MSA

    Conditional payment on what?
    If you exhaust the annual deposit made by the annuity...and bill Medicare for services... when Medicare pays... THAT is a ''conditional payment'' as like you provided in that link...Medicare 'expects' to be reimbursed. And you will reimburse Medicare from the next annuity deposit.
    Who sets up a custodial account and how much money does it cost to set one up and maintain it? Why do you really need a custodial account?
    I've already told you both... the custodial medical money is NOT accountable to Medicare...you can use that money for ANY treatment/service or 'toy' you wish. It is there for and medical that Medicare is not 'normally responsible for'. If you look in the "Medicare and You" booklet you will see that Medicare has limitations on what is approved annually. And even with the Part D medication...not ALL medications are approved for payment by Medicare...as you can only use the MSA money for what Mediare would normally be responsible for... there could be treatment/services/medication and even DME you may need that Medicare excludes. Those moneies would be out of pocket costs to you...WHY should YOU pay for ANY treatment or service related to your work injury EVER?

    Unless you are very poor at keeping records and not very good at keeping your investments in order and not touching your MSA account for any purpose that it was not intended to be used for I don't see why you would need a custodial account.
    I don't see why you would need one either...looks like you are all set ! As you are already set up with your accounts...and happy with what you have... congratulations ! There is no need for additional discussion.

    Smackman... ANY time Medicare makes ANY advance/conditional payment for ANYTHING related to your injury... they have a reasonable expectation of reimbursement. If you fail in this regard.. .they have recourse... by simply NOT providing benefits until those monies have been reimbursed.

    Your goal is to settle out the medical of your claim as your intent is to control the medical to your injury. Whether that is to your advantage, or best interest doesn't appear to be the major concern here. So just keep rephrasing the questions... soon you'll be in a position to grasp the intent of my responses. One the other hand... since your intelligence is above that of most other IW's... maybe it won't be necessary to keep responding here.

  7. #27
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Self Administrate MSA

    If you read through the link here http://www.cms.hhs.gov/WorkersCompAg...tterErrors.pdf ... Top Ten WCMSA Submitter Errors... go to #7... "No proposed medical set aside amount.

    EVEN CMS is looking for 'custodial medical' monies...that's why the WCMSA - Related Topics page states...
    These arrangements are established in order to pay for all medical expenses resulting from work-related injuries or diseases; they are not designated to simply pay portions of medical expenses for work-related injuries or diseases.http://www.cms.hhs.gov/WorkersCompAg....asp#TopOfPage

  8. #28
    Join Date
    May 2007
    Posts
    408

    Default Re: Self Administrate MSA

    Quote Quoting BvIA View Post
    Smackman... ANY time Medicare makes ANY advance/conditional payment for ANYTHING related to your injury... they have a reasonable expectation of reimbursement. If you fail in this regard.. .they have recourse... by simply NOT providing benefits until those monies have been reimbursed.

    Your goal is to settle out the medical of your claim as your intent is to control the medical to your injury. Whether that is to your advantage, or best interest doesn't appear to be the major concern here. So just keep rephrasing the questions... soon you'll be in a position to grasp the intent of my responses. One the other hand... since your intelligence is above that of most other IW's... maybe it won't be necessary to keep responding here.
    I said and I quote:
    My intelligence on MSA is above the average IW. I have spent many hours reading information about MSA accounts, funding of MSA accounts, and settling with WC. Most IW do not have a MSA to worry with.

    You know I meant that I know more about MSA's than most IW because most never deal with a MSA, There is no sense in being a Ass.

    How many individuals who post on this forum discuss a MSA? Very few.

    For anyone who took my comment wrong I apologize; I am just a country "boy" trying save my tail in this WC System. I have spent numerous hours studying MSA's. Do not let BviA spin this.

    BviA, I am really suprized at your outburst. When someone questions you, It upsets you; My intent is not to rephrase a question; My intent is to try and understand. If someone questions your answers, you take it as a slap in the face.

    It upsets me on your response but life will go on.


    Quote Quoting BvIA View Post
    If you exhaust the annual deposit made by the annuity...and bill Medicare for services... when Medicare pays... THAT is a ''conditional payment'' as like you provided in that link...Medicare 'expects' to be reimbursed. And you will reimburse Medicare from the next annuity deposit.
    I've already told you both... the custodial medical money is NOT accountable to Medicare...you can use that money for ANY treatment/service or 'toy' you wish. It is there for and medical that Medicare is not 'normally responsible for'. If you look in the "Medicare and You" booklet you will see that Medicare has limitations on what is approved annually. And even with the Part D medication...not ALL medications are approved for payment by Medicare...as you can only use the MSA money for what Mediare would normally be responsible for... there could be treatment/services/medication and even DME you may need that Medicare excludes. Those moneies would be out of pocket costs to you...WHY should YOU pay for ANY treatment or service related to your work injury EVER?

    I don't see why you would need one either...looks like you are all set ! As you are already set up with your accounts...and happy with what you have... congratulations ! There is no need for additional discussion.

    Smackman... ANY time Medicare makes ANY advance/conditional payment for ANYTHING related to your injury... they have a reasonable expectation of reimbursement. If you fail in this regard.. .they have recourse... by simply NOT providing benefits until those monies have been reimbursed.

    Your goal is to settle out the medical of your claim as your intent is to control the medical to your injury. Whether that is to your advantage, or best interest doesn't appear to be the major concern here. So just keep rephrasing the questions... soon you'll be in a position to grasp the intent of my responses. One the other hand... since your intelligence is above that of most other IW's...
    maybe it won't be necessary to keep responding here.


    No problem, I do not want to steal your Thunder.

  9. #29
    Join Date
    Jan 2008
    Location
    New Oxford, Pa. USA
    Posts
    430

    Default Re: Self Administrate MSA

    Smackman,

    Why then in your first post you were looking for help i.e. input, when you get it and you do not agree with it let it be, instead of every time biting the hand that wants to help.

    I do not always agree with people and sometimes I might not have phased an answer correctly and if I get someone whom has the correct answer all the better.

    Take a chill pill

    nipper

  10. #30
    Join Date
    May 2007
    Posts
    408

    Default Re: Self Administrate MSA

    Quote Quoting nipper123 View Post
    Smackman,

    Why then in your first post you were looking for help i.e. input, when you get it and you do not agree with it let it be, instead of every time biting the hand that wants to help.

    I do not always agree with people and sometimes I might not have phased an answer correctly and if I get someone whom has the correct answer all the better.

    Take a chill pill

    nipper
    Asking a Individual who has given the same answer numerous times IF they have a MSA or do they Self Administrate there MSA or do they actually utilize a Custodial Account is not biting ones hand off IMO.Please go back and read the postings especially post 7 and 8.

    You will notice after the 3rd post that you are the only other poster besides smackman, BVIA, AND maw19531 in 29 postings. This was a serious discussion.

    I do not know if BVIA has all the correct Answers;
    Neither do I.
    I know that me and maw19531 agree and maw has a MSA and Self Administrates his MSA.
    Look Nipper, I know you have a bone against me from a previous thread. Please Open your mind and reread the postings; Thats all I ask.

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