This is a common source of confusion over whether a Medicare Set-Aside allocation (MSA) needs to be prepared when a claimant/plaintiff is entitled to Medicare benefits, but not necessarily enrolled.

To be clear, the need for an MSA is based upon entitlement to Medicare benefits, not actual enrollment. Claimants/Plaintiffs will always retain entitlement regardless of plans to move to another country or intent to utilize group health insurance or VA benefits for treatment fo their work injuries. A claimant/plaintiff can never waive entitlement to Medicare as far as CMS is concerned. Therefore, employers/carriers should be cautious of offers from claimants to indemnify them in lieu of making a proper and/or adequate set-aside allocation.

For more information on when an MSA is required, contact us at the toll free number below.


    MEDVAL     1-888-SET-ASIDE (1-888-738-2743)

    Medicare Set-Aside Allocation/Arrangement Recommendations
    Submissions to Centers for Medicare and Medicaid Services
    Post-Settlement Administration
    Pharmacy Benefit Management

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