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Desperate for answers California IC offered me cash to buy my life medical - Printable Version

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Desperate for answers California IC offered me cash to buy my life medical - Sugarpuss44 - 08-23-2017

Herniated 3 lower discs at work 1996 California.awarded lifetime medical but last few years i have paid my own pain drugs.lawyer says IC is offering me $100K less 15% to them.I'm afraid! Do i get that Money or does medicare get it ? What are they not telling me. My future medical is likely drugs and office visits to dr.I've had for 29 years now.They want my signature this morning. Please help me understand . I'm 68 and no one willing or able to help me . thanks for any help. Marcia


RE: Desperate for answers California IC offered me cash to buy my life medical - 1171 - 08-23-2017

What do the settlement papers say?
You need to review basic Medicare Set aside guidelines.
https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Workers-Compensation-Medicare-Set-Aside-Arrangements/WCMSA-Overview.html
How/when it's paid depends on how the settlement is worded.
If no one is helping you, object to paying your atty 15%.
Did Medicare pre-approve the amount or is there set aside language in the settlement?
These questions should all be worked out during negotiations and long before there is any agreement to settle.
Have you thought of switching attys? There is only one fee shared.


RE: Desperate for answers California IC offered me cash to buy my life medical - California_Help - 08-23-2017

(08-23-2017, 10:04 AM)Sugarpuss44 Wrote: Herniated 3 lower discs at work 1996 California.awarded lifetime medical but last few years i have paid my own pain drugs.lawyer says IC is offering me $100K less  15% to them.I'm afraid! Do i get that Money or does medicare get it ? What are they not telling me. My future medical is likely drugs and office visits to dr.I've had for 29 years now.They want my signature this morning. Please help me understand . I'm 68 and no one willing or able to help me . thanks for any help. Marcia

I agree with 1171. Your attorney needs to sit down with you and explain everything. If there is a Medicare set aside he should be going over that with you.

Can I ask why you have been paying for your own medications? If they were denied through work comp and you have drug coverage from Medicare, Medicare may pay for them. If you were denied medications due to the UR or IMR system you doctor can make the request again after 12 months of the denial. It depends upon your own situation but for many getting out of this system can be a good thing, if you have alternative insurance. Dealing with UR and IMR can be very frustrating and can limit medical treatment. (JMO)


RE: Desperate for answers California IC offered me cash to buy my life medical - 1171 - 08-23-2017

20 yr old claim and they want her signature in a few hours???
Somethng is not right.....something has changed dramatically very recently.
Smells like they know something critical that she doesn't.....
Not always a good sign of an honest deal.


RE: Desperate for answers California IC offered me cash to buy my life medical - 1171 - 08-23-2017

Desperate:
Hope the information helped with this mornings decision.


RE: Desperate for answers California IC offered me cash to buy my life medical - California_Help - 08-23-2017

(08-23-2017, 04:52 PM)1171 Wrote: Desperate:
Hope the information helped with this mornings decision.

I was thinking it sounded a little off. They should also alert her if any of that money is considered already paid to her in past PD. I have seen injured workers settle and then found the settlement amount included past PD payments and they received a very small amount. I hope her attorney explained how much is going to the MSA too (if there is one).