Medicare Set-Asides

A CMS-approved Medicare Set-Aside is required following a Workers Compensation Settlement when the recipient is either a Medicare Beneficiary at the time of the settlement AND the total settlement is more than $25,000 or they have reasonable expectation of being a Medicare Beneficiary within 30 months and the total settlement exceeds $250,000. Medicare may also require proof that their interests were considered, even CMS approval is not required.

Spruance & Associates, Inc. has trained professionals on staff who have experience preparing Life Care Plans, Medical Case Management, and training from Medicare. We have four certified Medicare Set-Aside specialists.

Items needed for Medicare Set-Aside include: proposed settlement agreement, payout ledger from the past two years, and signed authorization forms.

Please contact our office if you have any questions as to whether an MSA is needed. You can refer an MSA to our office for either an allocation, submission or letter by contacting our office via phone or email.