If you've incurred any covered out-of-pocket expenses due to your injury, you can be reimbursed by simply submitting a receipt.

Submitting Receipts for Reimbursement

Receipts can be submitted through your CareGuard member portal. Alternatively, you also have the options to fax or mail them for review.

What Expenses are Eligible?

To ensure a smooth reimbursement process, make sure the expenses are directly related to your injury and are covered under your CareGuard policy.

Need More Information?

For further details on how to submit receipts or what qualifies as a covered expense, refer to your CareGuard member portal or contact their support.

As a CareGuard member, you always have full visibility into your account activity and savings with your CareGuard Member Portal.

Set Up Your Online Account in 5 Simple Steps

• Go to https://portal.careguard.com/#/login.
• Click 'Register'
• Complete the registration form by filling out your name, email, membership ID #, and then choose a password
  • Please reference you membership ID# on the back of your CareGuard card during registration
• Click ‘Register’ on the registration form 
• Please finish setting up your account by clicking the validation link sent to your email

When a member's CareGuard account earns interest, that interest is subject to federal taxes, similar to any other bank account interest. If the account earns more than $10.00 in interest, the member will receive a 1099-INT form.

 Using MSA Funds for Tax Payments

Members with a Medicare Set Aside (MSA) account have the option to use these funds to cover taxes on the interest earned by their CareGuard account, as permitted by Medicare guidelines.

 Details on Taxation and Reporting

It’s important to note that federal taxation applies to the interest earned on any account, including CareGuard accounts. The 1099-INT form will reflect the amount of interest earned and helps ensure accurate tax reporting.

For more complex inquiries or specific guidance on managing your CareGuard account and handling taxes, it is recommended to consult the appropriate reference materials or a tax professional.

With your CareGuard membership, you're free from utilization reviews. This means that most of the time, as long as your treatment is related to your Medicare Set-Aside (MSA) claim and is covered by Medicare, it will be taken care of. In some cases, there are no restrictions on your covered treatment's scope, leaving your treatment plan primarily between you and your doctor.

How CareGuard Membership Affects Treatment

With CareGuard, the focus is on granting autonomy in your treatment choices, letting you bypass typical utilization reviews that might otherwise limit your care.

Covered Treatments and Expenses

Your treatment expenses are generally covered if they relate to your original claim and meet Medicare's coverage criteria.

Are There Any Limitations on Covered Treatments?

In certain situations, your CareGuard membership might offer a treatment plan without limitations, supporting a wide range of covered options.

Ametros can negotiate treatment and service prices by running bills through our network to reprice them to the appropriate fee schedule or apply network discounts. If a provider is within our network, we often deliver additional savings beyond the usual and customary prices. 

How Much Can You Save with Ametros? 

Through Ametros’ discount networks, members can save an estimated 62% on provider visits and approximately 28% on prescriptions. Our team meticulously reviews every bill to identify possible savings, ensuring your funds last longer. 

What Happens with Large Bills or Out-of-Network Providers? 

For significant bills or services with providers not in our network, CareGuard’s team actively attempts to negotiate discounts, striving to reduce costs for our members. 

More Details on Ametros Negotiation and Savings 

Ametros enhances members' saving potential by incorporating network discounts and diligently reviewing each bill for further savings. For complex pricing scenarios or larger bills, the team negotiates directly with providers to secure favorable terms. 

If you wish to understand more about how Ametros manages bill negotiations and pricing strategies, please contact our support team

If the yearly funds in your Medicare Set Aside (MSA) account run out, Ametros will assist in coordinating with any secondary insurance or payment options you may have, such as Medicare coverage.

How Secondary Insurance Works

Typically, your secondary insurance will cover the remaining balance of your bills. For individuals with a Medicare Set Aside, Medicare becomes the secondary payer. Note that when using secondary insurance, you are still responsible for any deductibles and copays, either personally or through the insurance.

Role of Annuity in MSA

If you have a Medicare Set Aside and an annuity, once your account is replenished, CareGuard will resume its role as the primary payer with your MSA funds.

Managing MSA Fund Shortages

For detailed guidance on handling situations when your MSA funds run out, consult Ametros for assistance with secondary insurance options. If you have further questions, exploring MSA management strategies can be helpful. For more information, check out our Medicare Set-Aside resources.

After settling your case, the carrier or employer no longer has any input into your treatment decisions.

Post-Settlement Treatment Management

Once a settlement is reached, you gain the autonomy to manage your treatment without influence from your employer or insurance carrier. It's important to consult with your healthcare provider to ensure you are receiving appropriate care tailored to your needs.

Why Is Employer Input Not Permitted?

Following a settlement, the legal and financial responsibilities shift, removing the carrier or employer from any decisions regarding your treatment. This change is designed to focus your care on medical necessity rather than financial considerations.

What Should I Do After the Settlement?

• Consult Your Doctor: Regularly discuss your ongoing needs with your healthcare providers.
• Understand Your Benefits: Familiarize yourself with any coverage or benefits you have after settlement, such as Medicare or private insurance.

Understanding the landscape of your medical treatment post-settlement empowers you to take charge of your health decisions without external interference.

Unused funds at the end of the year will not go to waste. Instead, they will remain in your account and automatically roll over into the next year.

How Do Unused Funds Roll Over?

When you have remaining funds, these are carried forward, allowing you to continue utilizing them in the future. There is no penalty for not using all of your funds within the current year.

Is There a Limit on Rollover Funds?

There is typically no limit to the amount that can roll over, but it can vary depending on specific account terms. It’s important to review your account details or contact your account provider for specifics about rollover limits or restrictions.

Need More Information?

For more detailed information on unused funds and account specifics, you may want to consult the official guidelines provided by your account service or reach out to customer support for tailored guidance.

With your CareGuard membership, you're free from utilization reviews. This means that most of the time, as long as your treatment is related to your Medicare Set Aside (MSA) claim and is covered by Medicare, it will be taken care of. In some cases, there are no restrictions on your covered treatment's scope, leaving your treatment plan primarily between you and your doctor.

How CareGuard Membership Affects Treatment

With CareGuard, the focus is on granting autonomy in your treatment choices, letting you bypass typical utilization reviews that might otherwise limit your care.

Covered Treatments and Expenses

Your treatment expenses are generally covered if they relate to your original claim and meet Medicare's coverage criteria.

Are There Any Limitations on Covered Treatments?

In certain situations, your CareGuard membership might offer a treatment plan without limitations, supporting a wide range of covered options.

You have the flexibility to treat with any doctor or pharmacy of your choice when using CareGuard. They do not need to be part of our network for you to access CareGuard services and potentially benefit from discounts on healthcare expenses.

Choosing a Doctor or Pharmacy

With CareGuard, you aren't restricted to a specific network. This allows you to select healthcare providers that best suit your personal needs.

Benefits of Using CareGuard Network Providers

While it's not mandatory to use CareGuard’s network providers, many members opt to do so to maximize savings on every visit. Using network providers often results in significant cost reductions.

Final Details and Savings Potential

To fully understand the savings opportunities with CareGuard, consider reviewing your healthcare plans and options. If more information is needed, refer to our detailed guidance included with CareGuard's resources.

When a Workers' Compensation or liability settlement involves a Medicare Set-Aside (MSA), there are often specific terms in the settlement agreement about who will inherit the remaining medical settlement funds upon the death of the injured party.

Settlement Agreement Terms

Typically, the settlement agreement clearly outlines the beneficiary or beneficiaries who are entitled to any remaining MSA funds. Both the plaintiff and defense parties can negotiate these terms and stipulate how these funds should be distributed.

Beneficiary Designation

If a beneficiary is named in the settlement agreement, the funds are disbursed accordingly upon the account holder's passing. If no beneficiary is listed, the funds will generally pass to the account holder’s estate or follow the stipulations of their will.

No Beneficiary? What's Next?

In instances where no beneficiary is appointed, nor an estate plan or will exists, the account holder can designate a beneficiary with Ametros by completing a beneficiary form. This action ensures a clear path for disbursement.

Priority of Instructions

The executed settlement agreement's instructions have the highest authority and will always take priority in determining how funds are distributed. In all cases, Ametros does not charge an account closing fee or keep any remaining funds in the account.

Further Details and Assistance

For additional clarity on the process of MSA fund distribution upon death, reviewing the executed settlement agreement is crucial, as well as consulting with legal counsel if necessary. If you need to update your beneficiary information, consider reaching out to Ametros for guidance.

Ametros is staffed with a fantastic Care Advocate Team that are available to you 24/7, by email, phone or online chat. They are there to be your support system for questions, concerns, and to help coordinate your care.