Medicare Set-Aside

A Medicare set-aside is a custodial account intended to cover future, injury-related expenses so that Medicare does not have to pay for them. Instead of spending one’s settlement money on this or that, a portion of it has to be set aside to cover anticipated expenses that Medicare otherwise would have to pay. The idea is to save money for Medicare.

A Medicare set-aside is required if the settlement is –

  • $25,000 or greater, and the victim is 65 years of age or older, someone who is in receipt of Social Security Disability for 24 months or longer, or someone suffering from End Stage Renal Disease; or,
  • $250,000 or greater, and there is a reasonable expectation that the victim will be eligible for Medicare within 30 months of the settlement. There is a reasonable expectation of Medicare eligibility if the victim is between 62-1/2 and 65 years of age, has applied for or been denied Social Security Disability benefits, or has Renal Disease not yet in the end stage.

Few dog bite victims meet the requirements for a Medicare set-aside. If it is required, however, it must be accomplished at the time of the settlement, and of course the money earmarked for the set-aside account will not be available to the client.

For more information, see Medicare Set-Aside: FAQ by Atlas Settlement Group Inc.