Summit Structured Settlements
755 S.E. Frontier Suite 101
Waukee, Iowa 50263
Voice: 515.987.6888
Fax: 515.987.6999
Toll Free: 866.267.1177
info@summitsettlements.com
Disclaimer
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Medicaid preservation
As professionals, the members of Summit Settlement Services are experienced in the
arenas of public benefit coordination. Whether there is a need for a Special
Needs Trust or a Medicare Set-Aside, our professionals understand how such
vehicles are crafted and employed to preserve public benefits. Assuring
availability of future dollars through a Structured Settlement annuity, while
preserving any available public benefits, takes knowledge and experience.
Summit Settlement Services has built a network of other professionals. Whether
it is associations such as the National Structured Settlement Trade Association
(NSSTA) or the National Association of Medicare Set-Aside Professionals
(NAMSAP), legal or financial professionals or experienced individuals, we have
the answers related to complex public benefits programs and settlement of your
claim.
Special Needs Trusts
It takes careful planning when money or property is being received by someone with a
disability. Otherwise, the ability to receive Supplemental Security Income (SSI)
and Medicaid benefits may be jeopardized. By setting up a "special needs trust",
most,if not all of these problems can be avoided.
Owning a house, a car, furnishings, and normal personal effects does not affect
eligibility for SSI or Medicaid. But other assets, including cash in the bank,
can disqualify you from benefits. For example, if you leave your loved one
$10,000 in cash, he or she won’t be able to get SSI or Medicaid.
How a Special Needs Trust Can Help
A way around losing eligibility for SSI or Medicaid is to create what’s called a
"Special Needs Trust". Instead of property being received directly, the money or
property can be sent to the Special Needs Trust.
An assigned trustee, will have complete discretion over the trust property and
will be in charge of spending money on the disabled person’s behalf. Because the
trust beneficiary has no control over the money, SSI and Medicaid administrators
will ignore the trust property for program eligibility purposes. The trust ends
when it is no longer needed -- commonly, at the beneficiaries death or when the
trust funds have depleted. When the beneficiary dies Medicaid has can assert a lien on the Trust property.
Once the lien issue has been resolved, the Trust property is then free to be distributed according to the
Trust document, probate, or other directing authority. If the Trust property is depleted,
Medicaid has no lien against the Trust.
Medicare Set-Aside
When a person is Medicare eligible, part of any injury settlement received for
future medical treatment must be “set-aside” and used to pay for medical
expenses that would normally be paid for by Medicare, if it were not for the
injury.
42 USC §1395y (b) (2) - If a settlement contains an amount for future medical
expenses, the settlement is considered the primary coverage for payment. The
regulations provide that if a reasonable portion of the settlement proceeds are
allocated, or set-aside, for expenses otherwise covered by Medicare, only the
allocated funds must be properly spent down; not the entire amount of the
settlement - 42 CFR §411.46-§411.47.
Federal law precludes Medicare payments for any item or service if payment has
been made or can reasonably be expected to be made by a responsible third party
(i.e. Workers Compensation or Liability or Health Insurance Company.
A Medicare Set-Aside estimate is prepared and sent to The Centers for Medicare
and Medicaid Services for their Determination of adequacy. Sounds simple, but in
reality can be very difficult in the throws of litigation.
A proper Medicare Set-Aside will co-ordinate and preserve your Medicare
benefits. |
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