Dutchy Wrote:Thank you Jayne for the warm welcome. Can I assume that you are not on medicare therefore, you did not needa msa
I am on medicare...It took me awhile to accept that I was totally disabled so I didnt apply for SSDI till after I settled....
........I love cats, I just cant eat a whole one by myself......
When you say medicare will pick up after all the settlement money is used up, do you mean the amount in the MSA acct or the total settlement amount. Thanks for your response, I appreciate any and all info. Love you ajun hugsssss lol
That means that when you use up the total amount of money that has been put into the medicare set aside (MSA) account for your medical settlement portion, then medicare will start paying the bills related to your injury. There are 2 parts to setteling your case. One is the indeminity portion which is your wages and the other is the medical portion of your settlement. They take the medicare set aside (MSA) only from the protion of your settlement that you are receiving for medical expenses. I hope this explains things to you better. If not, then ask away, if I can't answer it someone else can, I promise you. Take care!
Lumbar Laminectomy L5 - S1, Lumbar Disectomy L 4 -5, Cervical Microdisectomy C-4 -5, Cervical Anterior Fusion C 4 -5, Cervical Anterior Fusion C 5 - 6, Lumbar Disectomy, Laminectomy and Foraminotmy L 3 - 4, Cryo Surgery Lumbar. --Ongoing Problems..Ã‚Â Permanently Totally Disabled.
Thanks all, a lot to comprehend. I wasn't aware that this settlement consisted of 2 parts. Our attorney said that the MSA had to be a min of 10% of the total settlement. I believe MJC said a third party should handle MSA payments. Our attorney said we pick a bank, set us an account, and then just submit medical bills to the bank and they reinburse us. Is there a time limit on how long these funds are available? Is he simplifing this process of reimbursement? I really don't see using the aprox. $5K MSA as my husband has two knee replacements, having trouble with one and said he will never have another one. Our attorney told me that medicare could come back and request that the entire settlement be used for future medical bills, although he has never had it happen to him or heard of it. Apparently medicare usually looks at settlements of $250,000 and over for this purpose. Gosh this is so scary. Any thoughts?
CMS reviews settlements in the following situations:
* The claimant is currently a Medicare beneficiary and the total settlement amount is greater than $25,000; OR
* The claimant has a "reasonable expectation" of Medicare enrollment within 30 months of the settlement date and the anticipated total settlement amount for future medical expenses and disability/lost wages over the life or duration of the settlement agreement is expected to be greater than $250,000.
An individual has a "reasonable expectation" of Medicare enrollment if any of the following situations apply:
(a) The individual has applied for Social Security Disability Benefits;
(b) The individual has been denied Social Security Disability Benefits but anticipates appealing that decision;
© The individual is in the process of appealing and/or re-filing for Social Security Disability Benefits;
(d) The individual is 62 years and 6 months old (i.e., may be eligible for Medicare based upon his/her age within 30 months); or
(e) The individual has an End Stage Renal Disease (ESRD) condition but does not yet qualify for Medicare based upon ESRD.
A WCMSA should be placed in an interest bearing account. WCMSAs should also be administered by a competent administrator (the representative payee, a professional administrator, etc.). When a claimant designates a representative payee, appointed guardian/conservator, or has otherwise been declared incompetent by a court; the settling parties must include that information in their Medicare set-aside arrangement proposal to CMS.
In addition, the claimant may self-administer his or her own WCMSA, if permitted under State law. Claimant should submit an annual self-attestation form when monies have been exhausted.