Should the settlement agreement provide for items and services that are not covered by Medicare but later become covered?
A60. No. CMS had at one time contemplated and ultimately rejected a suggestion that an additional allocation within the Medicare Set-aside be provided so that medical services and prescription drug charges that were not covered by Medicare at the time the Medicare Set-aside was submitted, but later become covered, be transferred from the amount specified for non-Medicare covered items and services to the Medicare Set-aside. Comment: It is, however, a prudent course of action to have a separate medical allocation (not a Medicare Set-aside) for non-Medicare covered items that the injured party may incur in the future and which are related to the injury or illness. This certainly can assist in the calculation of any Social Security Disability offset since this separate medical allocation would still be deemed an excludable medical expense. These funds do not have to be transferred to the Medicare Set-aside or be included in the annual Medicare Set-aside accounting. Q61. May administrative
Related Questions
- Should the settlement agreement provide for items and services that are not covered by Medicare but later become covered?
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