Medical Set-aside Accounts
Most workers compensation claimants who settle the medical portion of their claims with a Medical Set-Aside Account (“MSA”) are provided with unintelligible instructions printed off from the Centers for Medicare & Medicaid Services (“CMS”) website or taken from the CMS determination letter. The confusion and uncertainty of this process creates difficulties and anxiety for the claimant and often makes it harder to settle cases. Now you can offer claimants one of two products that will greatly assist them in managing the MSA morass: Amethyst and the Careguard program.
Amethyst
Amethyst is a medical discount card that is tied to the claimant’s MSA bank account. Ametros has put together a network of medical and drug providers which offers substantial discounts to list pricing. With the medical network the claimant’s cost should be equal to or better than the workers’ compensation fee schedules in most states. Medical expenses charged to the card will automatically be paid from their MSA bank account. Whether the claimant’s MSA is funded upfront or over time with an annuity, when it is depleted for the year or for good, the claimant should be able to have Medicare pay their qualifying medical expenses. At the end of a CMS reporting period, the claimant can simply access their Amethyst account online and print out the report required by CMS. Everything is automated to ensure that the process is as easy as possible.
Careguard program
The Careguard program adds another level of administrative assistance. Claimants receive the same discount card that ties to an MSA bank account in Careguard’s custody. With this product Careguard administrators and monitors the expenditures to make sure that they can be charged to the MSA account, i.e. that the charges are Medicare eligible and are related to the compensated injury. At the end of the reporting period Careguard will file the report required by CMS. With Careguard everything is monitored and handled by Amethros. The cost of this product is a one-time upfront charge. There is the possibility for discounts for larger cases. Sometimes respondents will be willing to pay this charge, but even if they do not, it may be well worth it for the claimant to assume the cost of this comprehensive service. Contact Settlement Advisors to sign up or find out more about this product.
