Frequently Asked Questions

How long will it take for completion of a Medicare Set-Aside Allocation report?
Once the information needed for completion is received, you will receive the Medicare Set-Aside report in 7 days or less. Rush reports are also available upon request at no additional fee.

What are the criteria that the Center for Medicare and Medicaid Services (CMS) require to approve an MSA?
In order to complete your Medicare Set-Aside Allocation report we will need:

1. First Notice of Injury/Loss
2. Last 2-3 years of medical payouts
3. Last 2-3 years of medical records
4. Any medical documents stating Maximum Medical Improvement
5. Rated Age* (can be obtained from MSA or your annuity broker)
6. Completed Referral Form
7. Life Care Plan/Medical Cost Projection (if available)
8. Pharmacy Summary listing each medication and price (if available)
9. Legal documents and or Court orders supporting any denied or controverted body part (if applicable)
10. Estimated settlement amount
11. Claimant’s Medicare or Social Security Disability status (if available)

* MSA Settlements will obtain rated ages for you at no additional charge if needed

1. In which the injured individual is currently eligible for Medicare- and the settlement amount exceeds $25,000; or
2. If settlement value is over $250,000 (inclusive of indemnity, attorney fees and costs) AND the injured individual is reasonably expected to become entitled to Medicare within 30 months (e.g. the injured individual is currently receiving Social Security Disability benefits).

What items are needed if CMS approval is requested?
In addition to the above requirements, we will need the following items to obtain CMS for approval of the MSA:

1. Release forms signed by claimant
2. Method of administering the MSA (self or professional)
3. Method of funding MSA (annuity or lump sum)

How can I determine an injured individual’s Social Security/Medicare entitlement status?
MSA Settlements MSA can obtain this information for you but first an SSA release must be signed by the injured individual. Please not for SSD checks we must have the original SSA consent to send to the local SSD office.  Lien status checks can also be obtained but please note that this process can take 3 to 6 months to complete due to the SSA’s mandated procedures.