Medicare Set Aside Arrangements in Special Needs Trusts

One of the oft overlooked aspects of a special needs trust is the creation of a Medicare Set Aside arrangement (MSA).  An MSA is a projection of future Medicare costs over the lifetime of a plaintiff.  This money is earmarked for future injury-related costs that would otherwise be paid for by Medicare.  While there are nor set guidelines for reviewing injury suits that do not involve workers compensation, the Centers for Medicare/Medicaid Services (CMS) requires such settlements to reasonably consider Medicare’s interests and cites an MSA as the preferred method for illustrating a client’s future medical costs and their intent on considering Medicare’s interests.  It’s important that an MSA be embedded within a special needs trust so that the reserved funds will not to be counted as “available resources”.

Why do we need an MSA?

The most common mistake in the liability and special needs arena is the failure to consider Medicare’s interest in a settlement or establishment of a trust.  Failing to imbed an MSA in a special needs trust allows the MSA funds to be considered a countable resource, which can render the beneficiary ineligible for means-tested government benefits.  You can protect your client’s interests further by securing MSA monies using a qualified insurance annuity (structured annuity).  A structured annuity will allow for regular and timely benefits that are in most cases tax-free.  Failure to consider Medicare’s interests may also open the beneficiary to Medicare recovery efforts and possible loss of Medicare benefits.

Ensuring fund availability

In most cases involving less than $100,000, it makes sense for MSA funds to be self-administered. Medicare Set Asides involving greater amounts are likely best administered by a professional administrator or custodian.  Funds can also be dispersed using a special claim payment debit card.

Who we are

BMA West was founded in 2006 and provides expert Medicare Set Aside projections and supporting services to attorneys and their clients across the nation.  A grass roots team of expert nurses and experienced insurance professionals, our purpose is to ensure the protection of the beneficiary’s Medicare benefits, while helping to simplify and secure a client’s use of future medical care monies.

Feel free to call or write to discuss or refer a case!

(949) 830-2027 or glortiz@bmawest-msa.com

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