I have a question on the set aside issue as it is for me and my case. It was agreed on the amount of set aside the IC would give the guberment it share the attorney for the IC contacted mine and they agreed on amount on the basis mine could raise it if needed so both sides agreed.
The question I have is does this mean settlement is near? as the IC said it takes awhile for guberment to approve such things so the process started so there would be no wait time. The other thing is if it agreed as they would approve my care and pay for my injury after settlement would I not get set aside since guberment will not pay for my care on injury?
These are my questions I have thanks.
Sorry I do not know if I said question right so if I get my medical for my injury paid for by IC not set aside but open medical is what it is called do I get my set aside back to me? since guberment would not be paying for injury but IC would
medicare setasides can take months so it is a beginning but still a long way away
It sounds like a settlement is near, if both sides have agreed on amounts. A set aside is designed to cover your future medical costs while protecting the government and medicare from future expenses. In the past some injured workers with settlements did not manage their money well, and medicare ended up picking up the tab for medical expenses that should have been covered by IC money. A set aside is designed to protect the taxpayer by preventing that mismanagement.
Jayne is correct. It taks CMS a long time to approve these arrangements.
Ace25 and Jayne are correct. And the reason IC's (and all attorneys involved) now make sure everything is approved is because if they settle a claim without the proper set-aside amount, Medicare can come after them, their attorneys and your attorney for any money they put out in the future so they are real careful and it takes a long time.
There is some info on the background of Medicare Set-Asides on this website as an FYI.
http://www.workerscompensation.com/medic...asides.php
Thanks everyone yes it is more than enough put into the set aside I do not feel comfy in telling amount as everyone has diffrent amounts for things but it enough but the question is why should guberment get any if the IC is going to pay my medical??????? it is called open medical and if so why should guberment get it? since they will not be paying for any of my injuries than.
No need to tell the amount. It's no one's business and really has nothing to do with the question.
The government doesn't get any. What used to happen is, an injured worker would get hurt. The IC would pay and then settle for an amount that supposedly included future medicals paid. The IW would have all access to the money and use the money to pay bills, buy a new car, etc. then would have Medicare pay for their medicals.
Medicare finally said, you can't settle medical payments and let the IW spend it on other things and have us pay for the medical bills that should have been paid under workers comp. So they now require the WC settlement to include a set aside so they don't get "stuck" with payments they should not have to pay. This also applies to any personal injury claims (like a car accident, etc., not just WC)
Now you are in for a wait. My settlement talks began last year. The medicare set aside is in the works right now, and has been for months!
I don't see any closure for me for a long time. I'm just trying to warn you to be prepared for a long wait, as Medicare has a huge backlog!
Take care, Lilly
Medicare Set Aside Funds and Open Medical are two diffeerent things
A medicare set aside fund is not your money, but it is the IC's money set in a fund to pay any medical outlined in your injured body parts. If you die the IC then gets whatever money in the fund back.
I would suggest if your not comfy with the issue, is to then hire on an Administrator to handle the Medicare and Pharmacy issues. They will handle the funds, pay the bills, and send the required statements needed to Medicare. The set up fee for that is about $10,000.00 paid for by the IC.
Bad boy that is it I have not phrased the question right why should there be any government set aside when I wanted to say is medicare set aside, when there is going to be medical set aside?
these two things are diffrent correct? than why should I not receive payment from the one that is not being used as is this not taking from me twice? if I am going to get medical lets say from medical set aside than why would medicare set aside need money or flip flop.
Is this making more rhyme from my question sorry confused you folks but yes thanks BB that is the correct wording you gave me I hope this helps now.
I'm thinking your saying you will have an Open Medical on your settlement. Is that correct?
If so, then the Insurance carrier for your Work Comp Claim has to inform (CMS) Medicare that they are going to fund your open Medical.
But, if (CMS) doesn't agree, and wants money put away into a Medicare Set-Aside Fund, then the Work Comp Insurance must do so.
No mater what, any money paid or being paid for Medical for you, still isn't yours. That money is the money of the payor. Your not entiled to any of it. Unless it's to pay medical bills and prescriptions in relation to your work injuries only.