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See more about medicare set aside and what companies you should trust with your money and care. A Medicare set-aside (MSA for short) is a mechanism sometimes used in settlement when Medicare might have an interest in your workers’ compensation case. Generally, funds from settlement create the Medicare-set aside account. An injured worker then uses those funds after settlement to pay for medical treatment for the work injury. Medicare Set-Aside Allocation Cost Projection completed and submitted for approval by Center for Medicare and Medicaid Services (CMS). Required Release of Information forms obtained. Social Security and Medicare Status Determination.

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After there is a settlement in a workers’ compensation or personal injury liability case, the amount of the settlement that is “set-aside” for medical care must be put into a special account called a Medicare Set-aside Account or MSA Account.

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Medicare set aside

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Medicare set aside

The Medicare set aside agreement is a financial agreement. It puts aside some of a worker's workers' compensation settlement with the goal of paying for future medical services related to the illness or injury. These funds need to be spent on those expenses prior to Medicare paying for any treatment of the injury or illness. The way Medicare ensures that it does not pay bills for your injury until your settlement funds are spent is through a Medicare Set-aside Allocation (MSA). An MSA is projection of the cost of the future treatment for your injury including doctor’s visits, tests, surgical procedures, and medications.

Medicare set aside

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Medicare set aside

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A Medicare Set Aside account is a portion of of your settlement set aside to cover all future injury-related medical expenses for you that would normally be paid by Medicare. This article is authored by guest blogger, Deborah Robinson Stewart, National Manager of Medicare Set-Asides, Genex Services.


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Medicare could reasonably be expected to pay for injury-related medicals), then it is not advised to attempt to avoid a Medicare Set Aside. A Medicare Set-Aside is a cost projection of the future medical costs associated with a claim that are anticipated to be Medicare covered if there was not a primary payer available. The Medicare Set-Aside funds are placed in a separate interest bearing account and can be either professionally managed or self-administered. Funds from a Medicare Set Aside (MSA) account must be available to pay for a claimant’s medical treatment related to their underlying workers’ compensation claim otherwise covered by Medicare “during the course of the claimant’s life.” See Workers’ Compensation Medicare Set-Aside Reference Guide, v3.1, sec. 3.0.