Professional vs. Self-Administration for MSAs: Which is Right for Your Client?


Medicare Set-Asides (MSAs) are essential for protecting your clients’ Medicare benefits after a settlement. An MSA is an account funded with settlement proceeds and used to pay for injury-related costs that Medicare would otherwise cover. The account can be self-administered or professionally administered, but how does your client know which option to choose? Keep reading to learn more.

Medicare Set-Aside Requirements

The Centers for Medicare and Medicaid Services (CMS) strictly monitors MSA usage and reporting requirements. To ensure Medicare benefits are protected, it is critical to meet the following criteria:

  • The funds must be held in an interest-bearing account;
  • The funds may only be used for Medicare-eligible expenses related to the injury; and
  • Detailed annual reporting must be submitted to Medicare.

While some individuals may feel comfortable with self-administration, managing an MSA can be challenging while dealing with the implications of an injury. If MSA requirements are not met, the claimant is at a significant risk of losing their Medicare eligibility, which can have severe consequences for their healthcare.

What is Professional MSA Administration?

While it is not mandatory, Medicare recommends using a professional MSA administrator. Not only does a professional administrator maintain careful accounting and submit annual reporting, but also offers the following types of assistance:

  • Review and facilitate payment of medical bills;
  • Provide access to a network of discounted prescription drugs, medical equipment, and medical providers;
  • Have a team to answer questions, including pharmacists and medical experts; and
  • Offer telehealth resources and the ability to view the account online.

Most importantly, a professional administrator can provide your clients with peace of mind that their Medicare benefits are protected.

Contact Sage for Medicare Set-Aside Assistance

At Sage, we understand the importance of protecting Medicare benefits. Contact us today for more information about Medicare Set-Asides and preserving Medicare eligibility.