Medicare Set-Aside Trusts

A Medicare set-aside trust can be an important part of your Estate Plan. Medicare is the federal government’s principal health insurance program for people 65 years of age and over. It also covers those who are permanently disabled and those with end-state renal disease.

Under the Medicare Secondary payer program regulations, Medicare has a right of action to recover its payments from any entities – including a settlement recipient, benefits providers, suppliers, physicians, attorneys, state agencies or private insurers that received a third-party payment.

Some kinds of trusts are designed to help individual and their families preserve eligibility for public benefits. Our Protocols affiliate specializes in this area.

Medicare set-aside trusts and Medicare set-aside custodial agreements, for example, satisfy the Medicare secondary payer statute in a way that protects both claimants and insurers without jeopardizing or reducing eligibility for private, federal or state support.

A Medicare set-aside trust sets aside a portion of a settlement to privately pay for medical bills that Medicare would otherwise be required to pay. These funds serve as the primary payer, making Medicare the secondary payer. When the trust is exhausted, the claimant is eligible for Medicare benefits.

Setting up such a trust is complex and involves discovery of any conditional payments by Medicare, identification of affected claims, assessment of appropriate set-aside arrangements, preparation and submission of a detailed proposal to the Centers for Medicare and Medicaid Services, and all necessary follow-up to gain CMS approval and plan for administration of the trust.

We work closely with you and your family, public and private benefits providers, employers, business partners, professional services providers, fiduciaries and charitable organizations to make sure that your Medicare set-aside trust – as an important component of your Estate Plan – meets your unique personal and financial objectives.

Attorneys

Robert L. Sagrillo|Henry M. Kohnlein

info@sagrillokohnlein.com