Medicare Set Aside

In workers’ compensation cases in which the injured party is a Medicare recipient or is expected to be a recipient within 30 months of the date of settlement, or when the amount of settlement is over $250K, Medicare’s interests must be considered. If not, 42 U.S.C. Sec 1395Y provides that the Center for Medicare and Medicaid Services (CMS) can levy certain potential penalties against a workers’ compensation carrier or self-insured corporation as well as the injured party. The solution is a Medicare set-aside.

A Medicare set-aside amount is determined through an analysis of the particular case, and it becomes the primary fund for paying Medicare-covered expenses compensable to the injury. Once the allocation is exhausted, Medicare becomes the primary payer of those expenses.

NFP Structured Settlements works with partners who provide the services required to help keep you in compliance.

Other Common Types of Trusts:

  • Special Needs Trusts/Supplemental Needs Trusts
  • Pooled Income Trusts/Community Trusts
  • Settlement Preservation Trusts
  • Qualified Settlement Funds