Would you buy a house if you didn’t know its price or the ongoing cost of your mortgage? It seems like a ridiculous question, but many claimants are asked to make decisions of the same magnitude on the non- Medicare covered portion of their settlements with little to no reliable information. Most of the time, claimants don't know the current cost of their medical treatment nor the future expected increases. While a Medicare Set Aside may provide a vote of confidence to the claimant for the MSA portion of their settlement, given Medicare approves the amount, the costs that would not be covered by Medicare (also known as “non-qualified costs”) can be particularly daunting. Many adjusters try to avoid addressing the issue of non-Medicare covered items altogether in a settlement, but often times it is a necessary component of the offer and a very contentious one. Estimating the pricing on big-ticket items, such as facility costs, custodial care service and home health care can be extremely difficult and often result in many cases never reaching settlement. Working with a hands-on professional administration company, like CareGuard, you can gain transparency into real- world pricing for these items and reach a definitive number for the costs. What are some of the most significant non-Medicare covered expenses?
- Long Term Skilled Nursing Facilities
- Home health aides and custodial care services
- Home modifications
- Certain creams, gels & compounds (Lidocaine, Voltaren, )
- Medical supplies sold over the counter
- DME bathroom supplies
- Services like acupuncture, gym memberships, home IV therapy