For many people, a Medicare Set-Aside (MSA) is unfamiliar until it becomes part of a settlement, and it usually comes with a variety of questions: Which medical bills will the account pay? What happens at the pharmacy? Who keeps track of the funds?
Medivest’s Member Services Team gathered the questions we hear most often from new members about professional MSA administration. Whether you are receiving an MSA or helping someone plan or manage the medical portion of their settlement, these answers will help explain what professional administration can look like in everyday life.
Q: What is professional administration of my Medicare Set-Aside amount?
A: You will have an advocate to help guarantee your Medicare benefits do not become jeopardized. You will have an assigned case manager to help answer any questions or concerns for the life of the account. You will receive a Medivest card (much like an insurance card) where all you need to do is present the card when receiving medical goods or services.
Medivest will handle all the billing, processing, and payment for your ongoing Medicare-allowable expenses. Medivest will interface directly with Medicare and medical providers so you don’t have to. Plus, Medivest will also grant access to pharmacy & DME discount networks so your MSA funds can last longer.
Q: How does it benefit me to have my Medicare Set-Aside professionally administered?
A: Peace of mind – Medivest takes responsibility for complying with Medicare rules and regulations so you don’t have to worry about your Medicare benefits. Medivest also deals directly with providers and insurance plans to adjudicate bills so you don’t have to.
Financial – Medivest has secured preferred pricing for pharmacy & DME expenses that will allow us to pay discounted rates most people could not achieve on their own. Medivest also has a medical claims staff to negotiate with providers.
Ease of use – Medivest issues you a Medivest ID card just like an insurance card. All we ask you to do is present the card when you receive medical goods or services. Medivest handles the payments and coordination of insurance plans so you don’t have to.
Q: How do I get my medical bills paid with professional administration?
A: You will receive a Medivest ID card just like an insurance card that we ask you to present when you receive medical goods or services. The ID card instructs the provider to seek payment from Medivest. Also, leading up to the activation of your account, Medivest will have contacted your treating physicians to input our information into their billing system.
Q: How are my medications covered?
A: With professional administration, you do not need to change anything regarding your medications. Where you pick up your prescriptions and who you see does not have to change. We ask that you present your Medivest ID card when picking up prescriptions. The provider will seek payment directly from Medivest.
Q: Who controls my Medicare Set-Aside funds?
A: Medivest is hired as a custodian of your MSA funds. That means the money is 100% yours; we are simply a hired advocate to manage the medical expenses the MSA account must pay. Medivest does not take any percentage of your MSA funds for our fees. In fact, Medicare does not allow any administration fees to be taken out of the MSA account. The funds are strictly intended for injury-related and Medicare allowable expenses.
Q: What happens if I run out of money and still need treatment?
A: When the account completely exhausts, Medivest will notify Medicare. After a review to make sure the MSA funds were spent appropriately, Medicare will assume the role of primary payer. Your ongoing Medicare allowable expenses will be paid for by Medicare. Medivest will handle this transition from start to finish for you.
Q: Do you send me reports on the activity and balance in my account?
A: Yes, we do. We can send you accounting reports and updates as you wish. Remember, you will have an account representative to help with any questions or concerns you may have. There is no automated system or AI bots. You’ll deal with a real person.
During settlement, parties may establish an MSA, but questions often arise afterward as medical care and bills continue. Understanding who handles payments, tracks the account, and answers questions can help claimants and settlement professionals decide whether professional administration is a good fit.
If you have questions about an existing Medivest account or are considering professional administration for an upcoming settlement, our team is here to help. For questions, feel free to reach out to the Medivest representative in your area by clicking here or call us directly at 877.725.2467.
