Jim Jones Member Story
Before becoming a member with Ametros, Jim Jones suffered from a life-altering back injury after becoming seriously injured from repetitive hard labor all over the state of Indiana.
Before becoming a member with Ametros, Jim Jones suffered from a life-altering back injury after becoming seriously injured from repetitive hard labor all over the state of Indiana.
‘How will I manage my medical care on my own after settlement?’ ‘What is a Medicare Set Aside (MSA), why do I need one, and what is required of me if I have one? ‘How will I pay my medical bills and determine what is related to my injury?’ ‘Should I manage my own future…
Medicare is systematically denying MSA recipients’ claims, and with steady frequency. Produced with data from researchers at Research Data Assistance Center (ResDac), this is the first study of its kind analyzing quantitatively how often The Centers for Medicare and Medicaid Services (CMS) denies coverage for otherwise Medicare-covered items for individuals after settlement of an insurance…
CareGuard is Ametros’ best-in-class professional administration service that manages individuals’ future medical funds after a workers’ compensation or liability settlement. In fact, Medicare “highly recommends” the use of an administrator, like Ametros, to help manage future medical funds after settlement. Get our brochure to see the difference CareGuard can make with an individuals’ care after…
Download this informative article from our president, Porter Leslie, about Medicare set aside administration featuring experts in the industry.
Similar to reporting your taxes each year, you are required to keep CMS informed of how you use the MSA funds for the rest of your life or until they are completely exhausted.
Download our 2020 CareGuard one pager! Savings, Support, & Security After You Settle. CareGuard is Ametros’ best-in-class professional administration service that manages your future medical funds after your workers’ compensation or liability settlement.
We’ve debunked common myths about Medicare Set Aside Professional Administration just for you! Get the facts by downloading our guide now!
Ametros’ CEO, Marques Torbert, presented at Comp Laude about why practicing humanity in the workers’ compensation world is so important.
Find out the most common questions about Workers’ Compensation in this downloadable version of WC FAQs!
Led by Melissa Wright & Johnny Meyer, this in-depth webinar shows you what injured parties can expect after settlement.
This guide explains how settling future medical portions of settlements can benefit you, your transition to life post-settlement, and how Ametros can support and protect you throughout the settlement process!
Navigate to the official website of the US Department of Labor: Division of Longshore and Harbor Workers’ Compensation (DLHWC)
Learn the benefits of combining a structured settlement with professional administration to help manage the injured party’s medical settlement funds or Medicare Set Aside (MSA) post-settlement.
Watch our short educational video to learn the basics of how Professional Administration of a Medicare Set Aside works.
Find out the benefits of Professional Administration. We’ll answer some common questions regarding Professional Administration.
To see a real-life case study and the math behind why administration and structures are the best combination, click to download the whitepaper.
Do you have a case that involves a Medicare Set Aside allocation? Find out how professional administration can help you!
Learn all about the factors that go into choosing your Professional Administrator for a Medicare Set Aside!
Learn all about Professional Administration and its benefits in 7 easy-to-follow steps.
Ametros is the largest administrator in the country and takes its responsibility to maintain the security of its member’s accounts very seriously. We manage thousands of individual accounts for our CareGuard members. Ametros’ security protocols have been vetted by multiple Fortune 100 corporations and provide peace of mind for CareGuard members. Ametros complies with all…
Hear from our member, Charron, as she shares her experience with CareGuard, and how she has benefited from using our professional administration service!
Find out how CareGuard can help you manage and track your medical funds after settlement.
La tarjeta CareGuard funciona como una tarjeta de salud tradicional, pero sin copagos o cargos adicionales, ayudándole a recibir todo el cuidado médico que necesita.
Olvídese de las molestias, con CareGuard, usted tiene… La libertad de ver al médico que usted desee. Sin evaluaciones o restricciones.
The combination of professional administration and a structured settlement is the perfect pair to ensure injured parties are getting the best possible outcome for their life after settlement.
We’ve debunked common myths about Medicare Set Aside Professional Administration just for you! Get the facts by downloading our guide now!
Hear from real members using CareGuard & Amethyst, learn about their experiences, and find out how our settlement solutions have helped them post-settlement!
This guide shows the different triggers and scenarios when professional administration can be beneficial in helping cases move toward settlement!
Download this one page brochure that gives an overview on how Amethyst is the most innovative and easy to use tool to help you manage your future medical funds on your own, while making your funds last as long as possible.
In uncertain times, including what we are facing with the COVID-19 (Coronavirus) pandemic, Ametros can provide you with savings, support, and security to ensure your settlement funds last.
Learn how our full-service benefits advisory team to help all parties involved understand how to preserve their benefits!
Being a Boston based company, we understand that pronunciation is wicked hard. Ah-met-tros? Am-tross? A-metro-s? Find out how to say our company name.
CareGuard is the industry’s first fully-automated, affordable solution to professional administration for medical settlements and Medicare Set-Asides.
Amethyst secures discounted pricing- avg. 21%- for members on prescriptions, medical equipment purchases, doctor and hospital bills.
Download a PDF copy of our trifold brochure written for plaintiff attorneys
Download these slides that give an overview of Ametros services’ that can benefit adjusters.
Download a PDF copy of our trifold brochure for adjusters & risk managers
With Ametros Banking, powered by LendingClub, you now have a FREE, EASY, AND SECURE way to deposit your non-medical settlement funds, including your indemnity payments.
Download a PDF version of our trifold brochure that explains the benefits of Ametros for structured settlement brokers.
La Tarjeta de Salud Amethyst es segura, se vincula a su cuenta bancaria existente y le facilita todos los pagos relacionados la salud. Usted siempre mantendrá el control completo de los fondos de su acuerdo.
Download a PDF version of our trifold brochure tailored for injured individuals.
Download a copy of our PowerPoint slides that give an overview of Ametros’ services.
La Tarjeta de Salud Amethyst se vincula a y ahorros! la cuenta de banco del miembro y le ayuda a facilitar todos los pagos relacionados a su cuidado. Los miembros siempre mantienen el control completo de los fondos de su acuerdo.
Watch this short animated explainer video to understand the basics of Medicare Set Asides.
This guide was written to help you understand the process used by the Centers for Medicare & Medicaid Services for approving proposed WCMSA amounts.
This document, prepared in compliance with § 508 of the Rehabilitation Act of 1973, as amended, is intended to be used as a sample submission or checklist for a sample submission. Its publication is meant to aid submitters in organizing the information that is typically sent to CMS with a set-aside proposal. Cases using this…
If you have decided to self-administer your CMS-approved WCMSA, this Toolkit can help you manage your account appropriately and satisfy Medicare’s interests related to future medical care.
The Centers for Medicare and Medicaid Services (CMS) Official Website
Find out the most common questions about Medicare Set Asides in this downloadable version of Medicare Set Asides FAQs!
A MSA is a financial arrangement that allocates a portion of a settlement, judgment, award, or other payment to pay for future medical services.
Navigate to Medicare’s official website.
Find out if your test, item or service is covered. Medicare coverage for many tests, items, and services depends on where you live.
Navigate to the Social Security’s official Program Operations Manual System (POMS)
The Medicare Secondary Payer Recovery Portal is a secure web-based application that provides the ability to access and update certain Medicare Secondary Payer case-specific information.
This booklet provides a general overview of the MSP provisions and outlines your responsibilities.
Navigate to Medicaid’s official website.
Navigate to Medicaid’s official tools and guidance resources.
This memorandum supersedes the Part D and Workers’ Compensation Medicare Set-aside Arrangements (WCMSA) memorandum that was published on December 30, 2005.
The document discusses lump-sum commutation of future benefits and lump-sum compromise settlement.
This Regional Office letter clarifies CMS’ policy concerning how the Regional Offices evaluate and approve WC lump sum settlements to help ensure that Medicare’s interests are properly considered.
The purpose of this memorandum is to include policy regarding the exclusive use of the Centers for Disease Control (CDC) Table 1 (All American Table) when determining life expectancy…
What statutory law, regulations, or Federal case law supports/allows CMS to review proposed settlements of injured workers who are not Medicare beneficiaries? When dealing with a WC case, what is “a reasonable expectation” of Medicare enrollment within 30 months? How does Medicare determine its interests in WC cases when the parties to the settlement do…
Medicare Secondary Payer — Workers’ Compensation (WC) Additional Frequently Asked Questions
Medicare Secondary Payer (MSP) – Workers’ Compensation (WC) Additional Frequently Asked Questions
Use of WC Fee Schedule vs. Actual Charges for WC Medicare Set-aside Arrangement? Self-administration of a WC Medicare Set-aside Arrangement?
This memorandum includes policy regarding the inclusion of prescription drugs that Medicare will cover as of January 1, 2006, in Workers’ Compensation Medicare Set-aside Arrangements (WCMSAs).
This memorandum replaces the policy that was outlined in the answers to questions in the all associate regional administrators (ARA) memorandum.
This memorandum includes policy regarding the pricing of Implantable Devices and to replaces the policies regarding “Beneficiaries that Request Termination of a WCMSA.
The purpose of this memorandum is to clarify guidance provided in the Centers for Medicare & Medicaid Services’ April 3, 2009 and July 1, 2009 procedure memoranda regarding prescription drugs…
The purpose of this memorandum is to set forth CMS’ procedures regarding the methodology of pricing future prescription drug treatment costs/expenses in WCMSA proposals.
This memorandum clarifies the guidance provided in the Centers for Medicare & Medicaid Services (CMS) May 14, 2010 procedure memorandum regarding the Rated Age (RA) language to be included on WCMSA proposals
A WC Medicare Set-aside Arrangement can be established as a structured arrangement, where payments are made to the arrangement on a defined schedule to cover expenses projected for future years. In a structured Medicare set-aside arrangement, monies are apportioned over fixed or definite periods of time. In such cases, Medicare will not agree to cover…
The purpose of this memorandum is to replace Q/A #2 of the July 11, 2005 Memorandum with regard to the Centers for Medicare & Medicaid Services’ low dollar WCMSA threshold for Medicare beneficiaries.
This memorandum reiterates guidance provided in CMS’ July 23, 2001, July 11, 2005, and April 25, 2006 procedure memoranda regarding CMS’ WCMSA) proposal review thresholds…
One of the distinctions that Medicare regulations and manuals make between compromise and commutation cases is the absence of controversy over whether a WC carrier is liable to make payments.
When the parties to a Workers’ Compensation (WC) settlement present CMS with “life care plans” or similar evaluations prepared by non-treating physicians to support and justify their proposed Workers’ Compensation Medicare Set-aside Arrangements (WCMSA), Medicare will consider accepting such evaluations if the physician does all of the following:
Since the publication of the April 3, 2009 CMS policy memorandum announcing prescription drug reviews, which becomes effective June 1, 2009, submitters of Workers’ Compensation Medicare Set-aside Arrangements (“WCMSAs”) have raised several questions concerning how certain situations will be treated by CMS and the Workers’ Compensation Review Contractor (“WCRC”).
Notwithstanding any other provision of this title, no payment may be made under part A or part B for any expenses incurred for items or services…
Notwithstanding any other provision of this title, no payment may be made under part A or part B for any expenses incurred for items or services
In 1980, Congress enacted the first of a series of provisions that made Medicare the secondary payer to certain additional primary plans.
10 – Medicare Secondary Payer Provisions for Working Aged Individuals 10.1 – Individuals Subject to Limitations on Payment 10.2 – Individuals Not Subject to the Limitation on Payment 10.3 – The 20-or-More Employees Requirement 10.4 – Working Aged Exception for Small Employers in Multi-Employer Group Health Plans (GHPs) 20 – Medicare Secondary Payer Provisions for…
Contractors are required in professional and public relations activities to inform providers, physicians, other suppliers, and beneficiaries about the MSP provisions and that claims for services to beneficiaries for which Medicare is the secondary payer must be directed first to the primary plan where there is primary coverage for the services involved. The Medicare law…
If you have Medicare and other health coverage, each type of coverage is called a “payer .” When there’s more than one payer, “coordination of benefits” rules decide who pays first.
This publication provides information on the four categories of items and services not covered under Medicare and applicable exceptions.