Learning about MSAs

WCMSA Helpful Hints – Part 7 of 10

Submitting a Workers’ Compensation Medicare Set-Aside Allocation (WCMSA) is simpler in theory than in practice. Below is a common error often made when submitting a WCMSA to the Centers for Medicare & Medicaid Services (CMS), as well as some helpful hints to avoid the error. If you need more information or further help with settling claims or setting up a Medicare Set-Aside for a client, call 855.931.3003 or fill out the form.




Helpful Hint*

  • The submitter must give a proposed lifetime (not annual) set-aside amount and should show clearly how much of the total figure is for medical services and how much is for prescription drugs. The WCMSA Reference Guide, Appendix 5 (Sample Submission) provides a helpful format.
  • Confirm that the proposed amounts for medical services plus prescription drugs add up to the total proposed amount.
  • Verify that any pricing charts are consistent with the amounts shown in your cover letter.
  • Confirm that the proposed amount is consistent with the court documents or that any differences are explained.
  • If an annuity is involved, use lifetime payout amounts instead of annuity purchase prices and include the amount of proposed seed money/initial deposit.


Don’t take unnecessary risks during settlement! Protect your clients’ Medicare benefits with a MSA.  To get started or even if you just have questions about a particular case you’re working on, contact Medivest at 855.931.3003 or fill out the form.


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