Why is Medicare Involved in My Injury Settlement?  

Injured due to someone else’s negligence? You may be entitled to have your medicalrelated bills and expenses covered by the at-fault party. But how do personal injury settlements work, especially when the injured person has Medicare or will be receiving benefits in the near future?  

Personal Injury can be more legally complex when you are on Medicare. It is very important to understand how settlements and Medicare work together and how your settlement payouts are allocated…if not you could be held liable.  

The attorneys at Mickey Keenan Law explain the general connection and how our team can help your unique case: 


Common Personal Injury Benefits 


Injuries happen every day across the country. When someone is involved in an accident, personal injury benefits may include: 

  • Past Medical bills and on-going or future medical expenses such as rehabilitation 
  • Lost Wages & Loss of future earning capacity 
  • Out of Pocket costs caused 
  • Pain & Suffering Damages 
  • Death benefits (these go to the victim’s surviving family) 

What Is a “Medicare Set-Aside” and When Do You Need One? 


Have you been injured but also have Medicare? Medicare Set-Aside Arrangement (MSA) is a financial agreement that allocates a portion of your injury settlement to pay for future medical services that are related to the accident, illness, or disease.   

Medicare Set-Aside (MSA) laws are ever-changing and complex. They also require meeting certain legal obligations, otherwise, the injured person will be held responsible. Let’s look at how it all works together: 

Basically, an MSA shifts the burden of paying accident-related treatment from Medicare to the settlement funds.  So in essence, the at-fault party is paying for the future medical treatment and not Medicare. 

The government is serious about not paying for injuries until the settlement has been depleted and will hold the injured person legally liable if they do. Ultimately this means Federal law has designated Medicare as a secondary payer (MSP = Medicare Secondary Payer) and Medicare will not cover current or future medical costs until the injury-related medical expenses are exhausted.  




Current Federal law will hold anyone liable who uses Medicare  

to pay for his or her related medical expenses 

before using the personal injury settlement payout 


Remember: iyou are receiving Medicare (or will soon receive ityou may need a Medicare Set-Aside. This special trust will reimburse the government for future medical expenses related to your injury.  


 Why is Medicare Involved in My Injury Settlement? 


It is crucial for anyone that has Medicare or will be receiving Medicare to know that under Federal law, Medicare is considered a “secondary payer” (acting as other insurance available)from a personal injury suit or other claim (ex. Worker’s compensation). 

Personal injuries don’t just go away once a settlement happens, and future medical expenses could be much higher than your current bills, especially if your injury is severe. You have to take into account for your life expectancy and quality of life.   

This is where the Medicare Set-Aside comes in. Once you receive settlement money from an insurance company to cover your injuries and future medical treatments, Medicare wants to ensure that part of your settlement funds is spent on injury related care, before taxpayers begin paying for your injury through Medicare. 


Related > Don’t Settle for Less 


Does My Settlement Amount Matter? 


 Currently, setting up a Medicare Set-Aside is needed if: 


  • You are on Medicare and settling a personal injury claim for excess of $25,000.  
  • Your injury settlement is for more than $250,000 and you are expected to receive Medicare within 30 months of the settlement (common if you receive SSDI, which has a 24-month waiting period before Medicare benefits can apply). 


Get Help from a Dedicated Personal Injury Attorney 


Your personal injury lawsuit is meant to obtain payment for future medical care and to compensate you for your pain and suffering.  For years, Medicare Set-Asides have been used in personal injury cases, and the federal government has an extensive set of rules to follow.   

We’ll treat you like family and work with you to receive the best settlement from your claim. The personal injury lawyers at Mickey Keenan, P.A. will also help you with your MSA to make sure you are not held liable and the payments are being distributed as required. Have an experienced lawyer on your side. 


Don’t wait—call our Florida injury firm at 813-871-1300 for a free consultation. 


Our Testimonials
Previous Next