How does one "consider Medicare's interest" in a workers' compensation case? If an injured worker is already on Medicare, then Medicare should be put on notice of a workers' compensation claim as soon as possible, and Medicare should be reimbursed for any bills they mistakenly may have paid on account of the work injury out of any settlement. As far as future medical care is concerned, the best method that is recommended by the folks at Medicare is to prepare a Workers' Compensation Medicare Set Aside Arrangement (WCMSA) if future medical care is anticipated. A WCMSA is a financial arrangement where the parties allocate a portion of a workers' compensation settlement to future medical needs. A separate account is established where the money must be placed, and the funds must be depleted before Medicare will pay for any medical expenses incurred after the settlement that are related to the work injury. In limited circumstances, Medicare will review a proposed WCMSA and determine whether the parties have adequately considered Medicare's interest, and will either approve the arrangement or suggest an alternate arrangement. However, Medicare will not review the proposed set aside unless the settlement is $25,000 or more (if the injured worker is already on Medicare), or if the person has a reasonable expectation of being on Medicare within 30 months and the settlement is at least $250,000.00. (Note: the law is constantly changing in this area, but this information is valid as of June 19, 2014).
Workers can jeopardize their future Medicare entitlement if they do not adequately consider Medicare's interest in their settlements. As a result, if you are an injured worker who anticipates filing for Social Security Disability, has filed for Social Security Disability, is getting Social Security Disability, or if you are age 62 or older, you are advised not to settle your workers compensation case without at least talking to a lawyer about how to adequately protect Medicare's interest in the settlement.