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Medicare Set-Aside Share Planning


Individuals who receive financial compensation for a catastrophic injury should understand that there likely will be limits on how that money is spent. In particular, a portion of the settlement in personal injury and worker compensation litigation cases must be reserved for medical services and reimbursement of health care expenses properly covered by Medicare or Medicaid.

Medicare Set-Aside Share Planning centers on the creation of a trust that helps erect a firewall between settlement money spent for health care purposes related to a catastrophic injury and money spent for all other purposes. At ThompsonMcMullan, we help clients in these circumstances early in the process, getting involved before final numbers for a settlement are set and before the family commits to a structured settlement or a lump-sum settlement. This way we can ensure that our clients have the opportunity to weigh the terms of a settlement while understanding how much money will be steered to the Medicare set-aside pot and how much will be accessible for their other needs.

Among the keys to successful set-aside planning is to arrange for a reliable, capable person to serve as trustee and carry the ongoing responsibility of ensuring that the firewall remains intact. In addition, we establish clearly for our clients the specific limits on the money so that there are no surprises and they can plan confidently while not going astray of the extensive Medicare guidelines that govern set-aside planning and ongoing trust management.

Representative Experience

Our Medicare Set-Aside Share Planning practice includes:

  • Pre-settlement set-aside planning for future expenses
  • Guidance for erecting and managing a firewall to adequately set aside expenses for medical care related to personal injury
  • Establishing a trustee to oversee the set-aside trust and ensure expenses are properly disbursed
  • Participating as co-counsel or as guardian ad litem in the negotiation and approval of settlements on behalf of minors or incapacitated individuals

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