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Custodial Accounts
Self Administered Accounts




A Medicare Set-Aside (MSA) Custodial Account is an account used to administer funds consistent with the manner in which Medicare would administer payments. This custodial account facilitates the management of the Medicare Set Aside amount which has been approved by the Centers for Medicare and Medicaid Services (CMS). Upon receipt of CMS’ approval of the MSA amount, the custodial account is funded. The funding options are:
  • Full cash value of the MSA amount, or
  • Approved seed money of MSA amount, complimented by a fixed income stream funded via a structured annuity.

By taking over the time consuming task of validating and paying the correct expenses as well as handling all reporting and compliance with CMS standards, our professionally managed custodial account protects your future coverage and benefits. This built in quality control is attractive to both parties (you and Medicare) as our custodial accounts are managed to ensure funds are utilized only for the intended purposes (minimizing exposure for both parties).

The unprecedented growth of Medicare Set Asides has had a profound effect in securing the integrity of the Medicare trust (fund). However, in Workers’ Compensation (and liability) settlement cases, the agreement of all parties (insurers, plaintiffs, attorneys and Medicare) often falls short of its intended purpose. This has resulted in no standardized and secure means of managing and reporting the MSA fund usage to ensure compliance with Medicare’s provisions.

The need for this mechanism creates instant value for all parties:

Plaintiff/Claimant
  • Does not jeopardize benefit eligibility;
  • Provides guidance for use of MSA funds; and
  • Removes the burden of reporting.

Insurer and Attorneys
  • Provides peace of mind because the plaintiff is provided with a trusted resource to manage future care and avoid post settlement liability.

Medicare
  • Insures the approved allocated funds are used for their intended purpose, and;
  • Provides a uniform method to comply with disbursement and reporting obligations, as well as protecting ongoing entitlement to Medicare.


Finally, an extra layer of protection for your settlements.

A Medicare Set-Aside Allocation amount is determined through the detailed analysis of your particular case. Medicare considers the allocation to be the primary fund for paying Medicare covered expenses for your settlement-related injury. Once the allocation amount is exhausted, Medicare becomes the primary payor of the Medicare covered expenses for those settlement-related injury.



A Medicare Set-Aside Allocation amount is approved by CMS. The Custodian then builds an injury-specific profile for each MSA Account. The Custodian will only utilize the MSA funds for medical expenses that would otherwise be covered by Medicare.

Affiance Partners understands the Medicare rules and regulations. Accordingly, on your behalf, Affiance Partners will expend the proceeds in your MSA Account, including any income earned, on your reasonable medical expenses related to and associated with your medical needs as the result of the Workers’ Compensation or liability settlement. Medicare rules and regulations will not allow Affiance to expend the proceeds in your MSA account on expenses not ordinarily covered by Medicare, such as attendant care costs.

The account will only make payment upon receipt of the CMS approval letter and a copy of the Medicare card for those clients already on Medicare. If not currently eligible for Medicare, then injury related expenses that would have been covered by Medicare will be paid however information related to the date of Medicare entitlement must be provided.

After Affiance Partners receives verification of your Medicare eligibility, or date of Medicare entitlement and the CMS letter approving the MSA allocation, the Custodial Account becomes validated and the Custodian will begin to pay for all Medicare covered injury-related services. The Custodian will track all activity, generate and submit annual accounting of the MSA Account to CMS. Additional responsibilities include coordination of funding, immediate correspondence to CMS upon exhaustion of the account (on a temporary or permanent basis), and management of the Account’s distribution upon the Account beneficiary’s death.

Thank You for choosing Affiance Partners as your Medicare Set Aside Account Custodian.
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