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What is a Medicare Set-Aside Account?

On Behalf of | Mar 24, 2020 | Elder Law, Medicaid & Medicare |

Anyone that has been involved in a personal injury or workers’ compensation settlement may have heard the term “Medicare Set-Aside Account.” These accounts, often referred to as MSAs, are one of the many seemingly arcane practices associated with Medicare. They are also important.

The need for an MSA can have a significant impact on your long-term financial plans. What should you know? Here’s a brief overview.

The basics of a Medicare Set-Aside Account

The idea of an MSA is fairly simple. After a personal injury liability or workers’ compensation settlement, a portion of the funds may be set aside in an MSA. This money is specifically to be used for future medical care related to the injury in question.

The account helps ensure the taxpayer-funded Medicare program is not paying for health care costs it does not actually need to. Only once the MSA funds are exhausted will Medicare potentially begin paying those bills. If, however, the MSA money was improperly spent or you can not provide correct documentation, there may be some complications.

Is an MSA always necessary?

Not every personal injury liability or workers’ compensation settlement requires the creation of an MSA. In fact, its use is entirely voluntary. So why consider this type of account at all?

Under the law, Medicare is a secondary payer. That means the taxpayer-funded program will only cover an individual’s health care costs if there isn’t a primary plan or payer responsible for those bills. Something like a large injury settlement could potentially be considered a primary payer. That’s something an attorney would help you determine.

If Medicare discovers it has been paying for care that an injury settlement could have covered, then you may end up having to reimburse Medicare for those costs. This can be a huge financial shock, one that upends all of your careful financial planning.

When it comes to your health care, it is often better to be safe than sorry.