The Medicare Set Aside Program is federal legislation designed to prevent the shifting of responsibility for medical treatment from a primary payor or insurance carrier to Medicare.
The Medicare Set Aside Amount will be an amount of money set aside in an account to cover the expenses of an injured worker. This amount is based on the following and is reviewed by the Centers for Medicare and Medicaid Services for approval:
Physician recommendations
Comprehensive review of the medical records
Review of medical claim history
This money is in an individual account and can only be used for the medical expenses that Medicare would usually cover had it not been a work injury.
Our Medicare Set-Aside Allocators can determine the appropriate set-aside amount based on:
An expert analysis of the condition
Current treatment plan
Projected future treatment
Life expectancy
Medicare Set-Aside Allocations include several components: