Medicare Set Aside

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Latest post Wed, May 10 2017 6:10 AM by JamyeP. 8 replies.
  • Tue, Nov 15 2016 12:26 PM

    • I Am Julia
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    • PA
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    Medicare Set Aside

    I have a Medicare Set Aside from a Workmen's Compensation Claim that was settled 6 years ago.  I have never touched or used the money. I called the Insurance Company who pays me a small annuity (under $1,400.) per year) while a large lump sum is held by them how I can have the funds released.  They told me the money is mine 100% but to release it I need to contact attorney. My prior attorney is not around any longer. I understand that I can only get the funds released with a 'Qualified Order'  as defined in Section 5891 (b)(2) of the Code.

    Can anyone help or explain this to me and what would be my next step?

    Thank You

    I Am Julia

  • Tue, Nov 15 2016 8:38 PM In reply to

    Re: Medicare Set Aside

    I Am Julia:
    I understand that I can only get the funds released with a 'Qualified Order'  as defined in Section 5891 (b)(2) of the Code.

    That you seem to know that definition implies that you actually read the code which says, in part, that a "qualified order" is issued under the authority of an applicable state statute by an applicable state court.

    https://www.law.cornell.edu/uscode/text/26/5891

    I'll check it out and get back to you.

     

     





    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Tue, Nov 15 2016 9:01 PM In reply to

    Re: Medicare Set Aside

    The PA statute you're looking for is Title 40 - P.S. Insurance Chapter 40 Structured Settlement Act. Section 4003 address the Petition that you would have to file with a court to get the qualified order.

    http://www.singerasset.com/wp-content/themes/singerthm/pdfs/Pennsylvania.pdf

    PA Rules of Civil Procedure Rule 229.2 goes into more detail about what the Petition has to contain.

    http://www.pacode.com/secure/data/231/chapter200/s229.2.html

    Unfortunately, I have not been able to find any forms kits or instructions on how to write the petition so you'll either have to go to a law library to study up or you'll have to hire a lawyer to do it for you.

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Tue, Nov 15 2016 9:17 PM In reply to

    • I Am Julia
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    Re: Medicare Set Aside

    Yes, in PA.  Thank you for the links and information. I will do research to see my next step. I appreciate your help. :)

  • Wed, Nov 16 2016 4:50 AM In reply to

    • Drew
      Consumer
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    • Joined on Thu, Mar 30 2000
    • PA
    • Posts 51,417

    Re: Medicare Set Aside

    I simply do not know if such orders once granted are on file at local country courthouse ..they may well be ...and to go look at several and copy same may give you some good ideas ....also my local PA courthouse has a big library and on line sevices ..unadvertised but open to public ....and forms books for a lot of stuff .  

     

    IF nothing else it might be more cost effective to use attorney who has written several such orders earlier 

     

     

     



  • Thu, Nov 17 2016 7:38 PM In reply to

    • I Am Julia
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    • PA
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    Re: Medicare Set Aside

    Thank you for your reply.  I will check into the county courthouse (Phila), the office of judicial records, to see if there are any filings that I would be able to view.

    Today, I attempted 27 calls to random attorneys, to see if they would represent me to file this Petition for a Qualified Order and each and every one of them said they could not help me. Incredible! Moreso, Disappointed.  I'm lost as to finding an attorney who would do such, to help.

    btw any thoughts if it would be workmen's comp attorney or social security attorney, I should consult? I called workmen comp attys. today.  Am I maybe on the wrong track there? 

    Thank you.

  • Thu, Nov 17 2016 10:11 PM In reply to

    • I Am Julia
      Consumer
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    • PA
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    Re: Medicare Set Aside

    I want to say Thank You again..... your links have been very helpful.....

  • Tue, May 9 2017 10:42 PM In reply to

    • I Am Julia
      Consumer
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    • Joined on Tue, Nov 15 2016
    • PA
    • Posts 5

    Re: Medicare Set Aside

    Here it is six months later, and still trying to figure this out. I reached out to a network of PA attorneys to see if anyone knew of a procedure to get a lump sum payout on an MSA annuity that was not guaranteed and no one knew of such a procedure with the exception of filing a Petition to get a 'Qualified Order'. Ironically, although they all gave me same advice (Petition, qualified order) no one has the time to help me out at this stage and, I am even willing to pay them. So, today I spoke with a Dan, of XXXX Life Ins Co the (Assignee & the Annuity Issuer), and told him I was going to file a Petition for a Qualified Order and wanted their contact information.  He then advised me today, that No, the Petition, Qualified Order would not be accepted because they could not accelerate payments b/c it is a "Medicare SetAside" & it's never been done with a Medicare SetAside. I asked why not & he said just because it has never been done. Not being satisfied with that reason he gave with no substance, I am back to square one, posting on forums for my next step. Any new thoughts would be greatly appreciate. 

    Thank you adjuster jack if you can direct me or offer any thoughts.

  • Wed, May 10 2017 6:10 AM In reply to

    Re: Medicare Set Aside

    You CANNOT have those funds released to you.  The purpose of the set-aside is for payment of medical expenses and that's the only thing that money can be used for.  See:  https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Workers-Compensation-Medicare-Set-Aside-Arrangements/Downloads/WCMSA-Reference-Guide-Version-2_5.pdf

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