Medicare Set-Aside (MSA) Funds
MSA funds are typically where a large portion of your payout will go after you resolve your Workers’ Compensation case. The money you receive in order to accommodate your injury-related costs and losses comes in the form of MSA funds in order to make sure you spend the money you receive on healthcare-related costs.
Exhaustion of MSA Money
The way you allocate these funds is monitored by the Benefits Coordination and Recovery Center (BCRC) of the Centers for Medicare and Medicaid Services (CMS), which can be problematic for people who rush to spend their payout on household items, school tuition, car payments, and other things unrelated to medical care.
The BCRC keeps track of how you spend your MSA money and files expense reports, at which point they are reviewed in order to see if your expenditures constitute appropriate use of funds. Many people are unaware that their use of MSA funds is being monitored and are surprised when Medicare denies coverage at the point they need to pay for legitimately injury-related costs. However, if you exhausted your MSA funds but did not file an annual expense report, you may still find yourself being denied Medicare coverage.
Reinstatement of Medicare Coverage After MSA Fund Depletion
If this happens to you, you may typically appeal to the BCRC and inform the Medicare Administrative Contractors (MACs) that your spending was appropriate and injury related, they may reinstate your coverage and resume payment for medical bills and other such costs, even after you have spent all of your MSA funds.
We Can Help You Navigate Insurance, Medicare, & MSA Spending
At The Law Offices of Brian J. Mongelluzzo, we understand that the world of insurance and healthcare are complicated. We are here to make sure you have all the information you need to receive the coverage and payment you deserve, as well as keep track of your spending in a way that will ensure you retain access to necessary healthcare benefits.