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MSA Roll Call
#1
Does anyone on this forum use a Medicare setaside (MSA) to pay for there Injury after settlement of WC Claim?

If so, do you self administrate?

How has it worked for you?

Any knowledge you can share concerning a MSA and using it(pros and cons, things you know after the fact, etc.) would be valuable to future IW's who will have a MSA in there C&R Settlement.

I am settling and a MSA is in my future.

Thank you.
 
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#2
My husband is in the process of this. About a year ago an independent co. (I forget the name of it) came in with an estimate of what his medical will cost for life. We have never heard anything since. My husband talked to his attorney the other day to see what's happening and haven't heard back from him yet either. This would be self-administrated. Sorry I have nothing else. We've been on hold for a long time. Claim was 2003 and settled C&R in 2006.
 
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#3
capricorn Wrote:My husband is in the process of this. About a year ago an independent co. (I forget the name of it) came in with an estimate of what his medical will cost for life. We have never heard anything since. My husband talked to his attorney the other day to see what's happening and haven't heard back from him yet either. This would be self-administrated. Sorry I have nothing else. We've been on hold for a long time. Claim was 2003 and settled C&R in 2006.

Well, I am sorta in the same boat. I was injured in 2003.

In April 2009 we had a mediation in which we agreed to a C&R settlement.

The upfront cash settlement number was agreed upon contingent of approval of the MSA by all parties before it was sent to CMS.

I received the 1st proposal within a month. My Attorney and I agreed it was way to low so we sent it back with our concerns. The IC Company intentionally left out many things which were unacceptable.

We have not heard a word since. The MSA proposal cannot be sent to CMS(Medicare) until all parties agree with the MSA proposal being done by a third party vendor chosen by the IC.

I continue to receive a weekly check and my medical is being paid for so I am not overly concerned.
I do wonder what has happened. The WC IC was "gunho" to settle this but put the brakes on when we refused there 1st ridiculous Life Care Plan Proposal. Anyway.......... 6 years and counting.
 
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#4
just curious free:
since medicare is on the hook for care after MSA exhausted why did it matter how much it was?
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#5
[quote=1171]
just curious free:
since medicare is on the hook for care after MSA exhausted why did it matter how much it was?
With Medicare there will be copays to meet, prescription drug cost, out of pocket expenses whereas the MSA will not.
As long as the MSA is used for the work related injury only and would be Medicare approved charges, there is no copays, prescription drug cost etc. I know one individual who actually has a MSA. He has a debit card that pays out of a interest bearing checking account for his monthly doctors visits, prescription drugs etc. at 100% pay. When the MSA is exhausted, Medicare kicks in along with its copays, prescription donut holes etc....
The more money in your MSA, the longer you can hold off out of pocket expenses with Medicare. The prescription donut hole is a big expense for instance.quote]
[b]
[/b]
 
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#6
Use Caution, as I have seen Insurance Carriers then state they will Leave Medical open for the injured body part, then MSA isn't going to be needed. Yet they submit that information onto the CMS.

Open Medical can be a nightmare also.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#7
Bad Boy Bad Boy Wrote:Use Caution, as I have seen Insurance Carriers then state they will Leave Medical open for the injured body part, then MSA isn't going to be needed. Yet they submit that information onto the CMS.

Open Medical can be a nightmare also.

I have thought of this as a possibilty. If they do this, It will breach our agreement and I will see them in court.

My agreement states in writing signed by there Attorney's, My Attorney, The Mediator and myself that ALL PARTIES must agree to the MSA PROPOSAL BEFORE it is sent to CMS for approval.
 
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#8
Well, I understand the Breach, but to be honest, I don't know if the headache of open medical is with it neither. And once you settle, you will need to pay an attorney to fight your open medical case issues.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#9
In my husband's case at the C & R procedings his attorney put on record that he would represent my husband if/when there was a problem withhis open medical. It;s been 3 years since settlement and he has never had a problem with the open medical paying for anything. This is why he couldn't care less if it's open medical or a Medicare set-aside.
 
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#10
capricorn Wrote:In my husband's case at the C & R procedings his attorney put on record that he would represent my husband if/when there was a problem withhis open medical. It;s been 3 years since settlement and he has never had a problem with the open medical paying for anything. This is why he couldn't care less if it's open medical or a Medicare set-aside.

I also have not had a issue with open medical. The only problem I have is I will not recieve a cash settlement until the MSA is approved.
I do not consider this to be a issue neither because I continue to recieve a weekly check from WC.
The IC has to continue my weekly checks until the final settlement is signed which will not happen until the MSA is approved by ALL parties, It then has to go to CMS for approval.
I am in a win win situation here because every week I draw a paycheck, my settlement goes up because of this.
Currently, I can add $7000 dollars to my cash settlement and it goes up every week.
This is why I am not in a hurry. I realize this could change because it is WC but I will ride the wave while I can.
 
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