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.


For the latest news, updates, and commentary on Medicare Secondary Payer, workers' compensation, and liability issues visit the Medivest Blog. Read up on these current topics being discussed:

Copyright by Medivest 2024. All rights reserved.

The owner of this website has made a commitment to accessibility and inclusion, please report any problems that you encounter using the contact form on this website. This site uses the WP ADA Compliance Check plugin to enhance accessibility.