A WCMSA allocates a portion of the WC settlement for all future work-injury-related medical expenses that are covered and otherwise reimbursable by Medicare (“Medicare covered”). When a proposed WCMSA amount is submitted to CMS for review and the claimant (who may or may not be a beneficiary) obtains CMS’ approval, the CMS-approved WCMSA amount must be appropriately exhausted before Medicare will begin to pay for care related to the beneficiary’s settlement, judgment, award, or other payment.
What Are Workers’ Compensation Medicare Set Aside Arrangements?
WCMSAs - The Basics
WCMSAs - Structured
WCMSAs - Who Can Help & How approval is obtained
Structured WCMSAs - Review