Video
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.
Featured Resources
Video
MSA Self Administration: 5 Critical Things to Know About Managing Your Future Medical Funds
‘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…
Guides
A Study of CMS Policy on Treatment Denials for Injured Workers with a Medicare Set Aside
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…
Brochures
Savings, Support, & Security with CareGuard After Settlement
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…
Guides
8 Questions from Attorneys About MSA Administration
Download this informative article from our president, Porter Leslie, about Medicare set aside administration featuring experts in the industry.
Guides
Medicare Set Asides 101: The Top 10 MSA Mistakes to Avoid
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.
Workers' Compensation
Brochures
Live Worry Free with CareGuard
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.
Guides
Common Misconceptions: MSA Administration
We’ve debunked common myths about Medicare Set Aside Professional Administration just for you! Get the facts by downloading our guide now!
Video
Humanity in Worker’s Comp
Ametros’ CEO, Marques Torbert, presented at Comp Laude about why practicing humanity in the workers’ compensation world is so important.
Documents
Workers’ Compensation FAQs
Find out the most common questions about Workers’ Compensation in this downloadable version of WC FAQs!
Video
Webinar: Life After Settlement
Led by Melissa Wright & Johnny Meyer, this in-depth webinar shows you what injured parties can expect after settlement.
Guides
Top 5 reasons to Settle Your Case
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!
Helpful Links
US Department of Labor: Division of Longshore and Harbor Workers’ Compensation
Navigate to the official website of the US Department of Labor: Division of Longshore and Harbor Workers’ Compensation (DLHWC)
Audio
Ringler Radio: The Benefits of the Professional Administration and Structured Settlement Combination
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.
Professional Administration
Video
How Does Medicare Set Aside Administration Work Video
Watch our short educational video to learn the basics of how Professional Administration of a Medicare Set Aside works.
Guides
MSA 101: When to Engage a Professional Administrator
Find out the benefits of Professional Administration. We’ll answer some common questions regarding Professional Administration.
Guides
The Perfect Pair: Professional Administration and Structured Settlements Whitepaper
To see a real-life case study and the math behind why administration and structures are the best combination, click to download the whitepaper.
Guides
Medicare Set Aside Allocations and Professional Administration
Do you have a case that involves a Medicare Set Aside allocation? Find out how professional administration can help you!
Guides
How to Choose a Professional Administrator
Learn all about the factors that go into choosing your Professional Administrator for a Medicare Set Aside!
Guides
Step by Step Guide to Professional Administration
Learn all about Professional Administration and its benefits in 7 easy-to-follow steps.
Guides
Ametros Funds Protection
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…
Video
Hear from a CareGuard Member: Charron
Hear from our member, Charron, as she shares her experience with CareGuard, and how she has benefited from using our professional administration service!
Guides
What Happens After Settlement?
Find out how CareGuard can help you manage and track your medical funds after settlement.
Live Worry Free with CareGuard (Spanish)
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.
Your Guide to CareGuard (Spanish)
Olvídese de las molestias, con CareGuard, usted tiene… La libertad de ver al médico que usted desee. Sin evaluaciones o restricciones.
Brochures
Guides
The Benefits of Professional Administration & Structured Settlements
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.
Audio
Ringler Radio: Simplify Medical Expenses
We’ve debunked common myths about Medicare Set Aside Professional Administration just for you! Get the facts by downloading our guide now!
Guides
Member Testimonials
Hear from real members using CareGuard & Amethyst, learn about their experiences, and find out how our settlement solutions have helped them post-settlement!
Guides
When to Involve a Professional Administrator
This guide shows the different triggers and scenarios when professional administration can be beneficial in helping cases move toward settlement!
Our Products
Brochures
Start Saving with Amethyst
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.
Guides
Settlement During Difficult Times
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.
Guides
Protect Your Benefits with Ametros
Learn how our full-service benefits advisory team to help all parties involved understand how to preserve their benefits!
Video
How Do You Pronounce Ametros
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.
Video
Welcome to CareGuard Video
CareGuard is the industry’s first fully-automated, affordable solution to professional administration for medical settlements and Medicare Set-Asides.
Video
Welcome to Amethyst Video
Amethyst secures discounted pricing- avg. 21%- for members on prescriptions, medical equipment purchases, doctor and hospital bills.
Brochures
Ametros Overview Brochure for Plaintiff Attorneys
Download a PDF copy of our trifold brochure written for plaintiff attorneys
Slides
The Adjuster’s Guide to Ametros
Download these slides that give an overview of Ametros services’ that can benefit adjusters.
Brochures
Ametros Overview Brochure for Adjusters & Risk Managers
Download a PDF copy of our trifold brochure for adjusters & risk managers
Brochures
Free Banking Services Built for Your Settlement
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.
Brochures
Ametros Overview Brochure for Structured Settlement Brokers
Download a PDF version of our trifold brochure that explains the benefits of Ametros for structured settlement brokers.
Brochures
Start Saving with Amethyst (Spanish)
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.
Brochures
Ametros Overview Brochure for Injured Individuals
Download a PDF version of our trifold brochure tailored for injured individuals.
Slides
The Plaintiff Attorney’s Guide to Ametros
Download a copy of our PowerPoint slides that give an overview of Ametros’ services.
Brochures
Your Guide to Amethyst (Spanish)
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.
Medicare Set Asides
Video
What is a Medicare Set Aside Video
Watch this short animated explainer video to understand the basics of Medicare Set Asides.
Documents
Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide
This guide was written to help you understand the process used by the Centers for Medicare & Medicaid Services for approving proposed WCMSA amounts.
Guides
Sample Submission Checklist for a Workers’ Compensation Medicare
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…
Guides
Self-Administration Toolkit for Workers Compensation Medicare Set-Aside Arrangements
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.
Helpful Links
The Centers for Medicare and Medicaid Services (CMS) Website
The Centers for Medicare and Medicaid Services (CMS) Official Website
Documents
Medicare Set Asides FAQs
Find out the most common questions about Medicare Set Asides in this downloadable version of Medicare Set Asides FAQs!
Guides
Accepting Payment from Patients with a Medicare Set-Aside Arrangement
A MSA is a financial arrangement that allocates a portion of a settlement, judgment, award, or other payment to pay for future medical services.
Helpful Links
Medicare’s Website
Navigate to Medicare’s official website.
Helpful Links
Medicare – What Medicare Covers
Find out if your test, item or service is covered. Medicare coverage for many tests, items, and services depends on where you live.
Helpful Links
Social Security Program Operations Manual System (POMS)
Navigate to the Social Security’s official Program Operations Manual System (POMS)
Medicare Secondary Payer
Guides
Medicare Secondary Payer Recovery Portal User Guide – July 2, 2018 v4.2
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.
Guides
Medicare Secondary Payer Booklet
This booklet provides a general overview of the MSP provisions and outlines your responsibilities.
Helpful Links
Medicaid’s Website
Navigate to Medicaid’s official website.
Helpful Links
Medicaid Tools and Guidance
Navigate to Medicaid’s official tools and guidance resources.
CMS Documents
Documents
CMS Memo: Q&A for Workers’ Compensation Medicare Set-Aside Arrangements
This memorandum supersedes the Part D and Workers’ Compensation Medicare Set-aside Arrangements (WCMSA) memorandum that was published on December 30, 2005.
Documents
Lump-sum Payments
The document discusses lump-sum commutation of future benefits and lump-sum compromise settlement.
Documents
Workers’ Compensation: Commutation of Future Benefits
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.
Documents
Life Expectancy in Workers’ Compensation Medicare Set-Asides Proposal
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…
Documents
Workers’ Compensation Frequently Asked Questions (Part 1)
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…
Documents
Workers’ Compensation Frequently Asked Questions (Part 2)
Medicare Secondary Payer — Workers’ Compensation (WC) Additional Frequently Asked Questions
Documents
Workers’ Compensation Frequently Asked Questions (Part 3)
Medicare Secondary Payer (MSP) – Workers’ Compensation (WC) Additional Frequently Asked Questions
Documents
Workers’ Compensation Frequently Asked Questions (Part 4)
Use of WC Fee Schedule vs. Actual Charges for WC Medicare Set-aside Arrangement? Self-administration of a WC Medicare Set-aside Arrangement?
Documents
Part D and Workers’ Compensation MSA: Questions and Answers
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).
Documents
Workers’ Compensation: Commutation of Future Benefits [Update]
This memorandum replaces the policy that was outlined in the answers to questions in the all associate regional administrators (ARA) memorandum.
Documents
Pricing of Implantable Devices and Beneficiaries Requesting Termination of a WCMSA Account
This memorandum includes policy regarding the pricing of Implantable Devices and to replaces the policies regarding “Beneficiaries that Request Termination of a WCMSA.
Documents
Prescription Drugs for Medicare Beneficiaries
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…
Documents
Pricing Future Prescription Drug Treatment Costs
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.
Documents
Rated Age Language
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
Documents
Structured Set-Aside Arrangements
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…
Documents
WCMSA and Revision of the Low Dollar Threshold for Medicare Beneficiaries
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.
Documents
Guidance for Submission of a WCMSA Proposal
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…
Documents
Commutation vs. Compromise
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.
Documents
Life Care Plans Prepared by Non-Treating Physicians
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:
Documents
CMS Prescription Drug Set-Aside Guidance for Submitters
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”).
Documents
Exclusions from Coverage and Medicare as Secondary Payer [Part 1]
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…
Documents
Medicare’s Interest: Lump Sum or Structured Settlement
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
Documents
Chapter 1: MSP Background and Overview
In 1980, Congress enacted the first of a series of provisions that made Medicare the secondary payer to certain additional primary plans.
Documents
Chapter 2: MSP Provisions
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…
Documents
Chapter 3: MSP Provider, Physician, and Supplier Billing Requirements
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…
Documents
Medicare & Other Health Benefits: Your Guide to Who Pays First
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.
Documents
Items and Services Not Covered Under Medicare
This publication provides information on the four categories of items and services not covered under Medicare and applicable exceptions.
