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Medicare Set Aside

Medicare Set-Aside

Definition

An amount of money related to future medical expenses that must be reserved from an employee benefits, workers compensation, or auto insurance claim settlement that involves a Medicare-eligible claimant. The purpose of the set-aside is to protect Medicare from paying for medical benefits that should have been funded by the party responsible for causing the injury. Although applicable to general liability and automobile no-fault claims, the set-aside is most commonly a factor in workers compensation claim settlements. The Centers for Medicare and Medicaid Services (CMS) must approve the amount of the Medicare set-aside.

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