Medicare Set Asides And Your Workers’ Comp Settlement In Roanoke

A Medicare Set-Aside (MSA) can allow workers who are 65 or older to allocate part of their settlement to pay for future medical care related to their workplace injury before Medicare pays. If you wish to open a Medicare Set Aside account and don’t know what to do or where to start, our lawyers at Miller & Webb, LLP, are here to help. We have proudly represented injured workers throughout Southwest Virginia since 1986 and continue to serve our community from our Roanoke office.

Get the workers’ compensation representation you need today by calling 540-627-5131.

What An MSA Is And Why It Matters

An MSA is a financial arrangement that allows you to allocate a specific amount of your workers’ comp settlement to cover future injury-related treatment that Medicare would otherwise pay for. You must only use the funds for Medicare-approved injury-related expenses. Once the funds from these accounts run out, then Medicare kicks in. In practical terms, an MSA can help ensure:

• Your settlement accounts for future injury-related medical costs.
• Medicare coverage is protected for treatment tied to your work injury.
• You avoid unnecessary delays and disputes during settlement.

MSAs can be necessary for workers who are already Medicare beneficiaries or will become one within 2.5 years of their settlement. If your situation requires an MSA and is not handled properly, Medicare may refuse to pay for future treatment related to your injury until you spend your funds appropriately. That can create a serious problem years after your case is closed.

When Medicare Review Often Comes Into Play

While your case is unique to you, MSAs can become a roadblock when you are near Medicare eligibility or already receiving Medicare benefits. A widely used rule of thumb is the 30-month window: if you are within about 30 months of Medicare eligibility, you must carefully consider Medicare’s interests. In many cases, parties closely review MSAs when the settlement is substantial, often discussed in practice as $250,000+ or more for certain Medicare review situations.

How An MSA Can Affect Settlement Value And Timing

MSAs can affect settlement value and timing by slowing negotiations. That’s because they require medical projections, allocation work and agreement on how to fund future care. They can also affect the net amount you take home, as you may need to set part of the settlement aside for future injury-related care. We explain these tradeoffs clearly so you can make informed decisions.

How We Add Value In High-Stakes Settlements

We know MSAs can feel like they get in the way. However, they don’t have to derail your case. Attorney Miller and attorney Webb can help you navigate the process by coordinating the information needed to evaluate future care and by keeping filings and deadlines on track. That way, you can protect your claim while you wait for a final settlement. We also help you understand how ongoing treatment and work status affect settlement strategy in Virginia. Our work often includes:

• Identifying when an MSA issue is likely early in the case
• Gathering medical records and treatment projections for settlement planning
• Protecting your claim with timely filings to prevent it from being barred
• Negotiating efficiently so the MSA process doesn’t stall resolution

We understand how overwhelming all of this can be, as you may face many decisions to make and carry out. Our job is to provide you with the knowledgeable guidance you need so you can feel confident as you move through the process.

Talk To Us About Your Settlement

If you’re considering a settlement and you’re nearing Medicare age, we are here to help. We serve Roanoke and all of Southwest Virginia, and we’re ready to help you protect your benefits and move your case forward with confidence. Schedule an initial consultation with us today by calling 540-627-5131 or by completing our contact form.