Why It Is Your
We all know (or at least have heard) that Medicare costs are skyrocketing. As a countermeasure, the U.S. Congress enacted a collection of laws known as the Medicare Secondary Payer Act (commonly referred to as MSP). The basic premise is this: if someone is injured, and a source of funds (other than medicare) exists to pay for the past and future medical expenses as a result of that injury – such other source of funds should be used. Only when NO OTHER source of coverage exists, will Medicare pay for the medical treatment related to the injury (this, of course, assumes that the person in question is eligible to recieve Medicare benefits).
If Medicare pays for treatment that should have been paid for by anther source of funds or coverage, Medicare will seek reimbursement. Regarding prior Medicare payments (before settlement or recovery) this is a no brainer. Attorneys will take funds out of your settlement proceeds and repay the government. It is protecting medicare’s future interests that provides problems because, if an error is made, Medicare may elect to cut off a recipient’s future benefits.
To protect both the client and the attorney, personal-injury attorneys will recommend that their clients, with significant future medical expenses, create a Medicare Set Aside. (commonly referred to as an MSA).