What is a Medicare Set Aside (“MSA”) in California?

What is a Medicare Set Aside (“MSA”)? How does an MSA affect my Workers’ Compensation case?

A MSA is an estimate of your future medical costs due to your Workers’ Compensation injury. While these are not required in most cases, injured workers who are Medicare eligible (30 months from full retirement age) or those on Social Security of any kind (SSDI, SSI, etc.) are required to have a MSA before they can settle their future medical care with the Workers’ Compensation insurance carrier. This is so that the federal government is not left “holding the bag” for your medical care after the case is over.

Once a valid MSA becomes part of an approved Compromise and Release (total Workers’ Compensation settlement document), that part of your Workers’ Compensation settlement must be put into a separate, interest-bearing bank account. You can then use that account for any medical care you need in relation to your workplace injury. Once that account is properly exhausted, Medicare will treat your industrially injured body parts.

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