This is a common source of confusion over whether a Medicare Set-Aside allocation (MSA) needs to be prepared when a claimant/plaintiff is entitled to Medicare benefits, but not necessarily enrolled.
To be clear, the need for an MSA is based upon entitlement to Medicare benefits, not actual enrollment. Claimants/Plaintiffs will always retain entitlement regardless of plans to move to another country or intent to utilize group health insurance or VA benefits for treatment fo their work injuries. A claimant/plaintiff can never waive entitlement to Medicare as far as CMS is concerned. Therefore, employers/carriers should be cautious of offers from claimants to indemnify them in lieu of making a proper and/or adequate set-aside allocation.
For more information on when an MSA is required, contact us at the toll free number below.
MEDVAL 1-888-SET-ASIDE (1-888-738-2743)
Medicare Set-Aside Allocation/Arrangement Recommendations
Submissions to Centers for Medicare and Medicaid Services
Pharmacy Benefit Management
CMS MSAs medicare set-aside arrangements Turbo Tagger