About MSAs

What is A Medicare Set Aside?
A Medicare Set Aside, or MSA, is an account created in the settlement of a Workers' Compensation or liability case. It is funded using a portion of the settlement proceeds that is to be used to pay for future medical expenses related to the job injury/illness that would otherwise be payable by Medicare. Funds must be established in insured accounts and may be managed by the claimant or set up in a custodial account.

Why are MSAs needed?
Medicare laws and regulations state that responsibility for the future medical expenses associated with an injury should not be shifted from the responsible party to Medicare. For that reason, Medicare will not pay for any medical expenses related to an injury after a settlement, until the settlement allocated to future medical expenses covered by Medicare is fully exhausted. This means a portion of the settlement must be "set aside" to pay for the future Medicare covered expenses associated with the injury of the settlement. (42 C.F.R. 411.46).

How does Affiance Partners help?
The unprecedented growth of MSAs 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.

Affiance Partners provides an invaluable service to all parties by ensuring that MSA funds are properly administered and the beneficiary's benefits are protected.

What types of MSAs are available?
Every MSA submitted to the Centers for Medicare and Medicaid Services (CMS) must specify if the MSA funds will be self-administered by the claimant, or set up in a custodial account.

Affiance offers both custodial and self-administered options.  How do you know which one to choose?  In making this decision, key factors to consider include the dollar amount of the MSA, the sophistication of the Medicare beneficiary and his or her ability to follow numerous, changing MSA requirements.