Workers’ Compensation Medicare Set Aside Arrangements

A Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury, illness or disease.  These funds must be depleted before Medicare will pay for treatment related to the workers’ compensation injury, illness or disease.

All parties in a workers’ compensation case have significant responsibilities under the Medicare Secondary Payer (MSP) laws to protect Medicare’s interest when resolving cases that include future medical expenses.  The recommended method to protect Medicare’s interests is a WCMSA.

The amount of the WCMSA is determined on a case-by-case basis.  Please review the Determining if a WCMSA is Reasonable document to assist you with your WCMSA submission.

Additional information for attorneys, Medicare beneficiaries, claimants, insurance carriers, representative payees, and WCMSA vendors can be found in the WCMSA Reference Guide.