Once your Medicare Set-Aside (MSA) account is established, you can only use it to cover medical treatment or prescription drugs related to your workers' compensation (WC) claim. This spending is subject to Medicare guidelines, even if you're not yet enrolled in Medicare.
Restrictions on MSA Spending
Funds in an MSA are specifically allocated for treatments associated with the work-injury covered by Medicare. Spending these funds on non-covered items may lead to denied claims until proper usage of the full amount is demonstrated.
Importance of Adhering to Guidelines
If the MSA funds are used improperly, issues with Medicare coverage may arise. It's crucial to ensure that the expenses align with medically necessary services for the settled injury.
Consequences of Improper Usage
When funds from your MSA account are utilized incorrectly, Medicare may deny related claims. The account administrator must show appropriate use equal to the MSA amount for claim acceptance.
Detailed Guidance and Reference
For more detailed information, you can consult the Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements and the Workers’ Compensation Medicare Set-Aside Reference Guide.
