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FAQs Medicare Set Asides

Is getting the Medicare Set-Aside reviewed and approved by Medicare required?

No, obtaining approval for a Medicare Set-Aside (MSA) is not mandatory. Medicare offers a voluntary submission and review process for MSAs that meet specific thresholds. If an MSA does not meet these thresholds, it will not be reviewed by Medicare. However, if the MSA does meet the review criteria, parties involved in the settlement can choose to send the report to Medicare for review and approval.

Benefits of Medicare Set-Aside Approval

The primary advantage of having an MSA reviewed and approved by Medicare is the assurance that Medicare has deemed the amount sufficient to cover its interests. This helps mitigate uncertainty in cases where funds might deplete in the future.

Voluntary Submission Process

When deciding whether to submit an MSA for approval, consider that an unreviewed MSA leaves room for uncertainty regarding Medicare's acceptance of the settled amount.

Final Considerations

For those dealing with MSAs, understanding whether to opt for Medicare’s review process can impact the settlement's security and future fund sufficiency. More detailed information can be found in the WCMSA Reference Guide.

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