Medicare Set-Aside Trust Advisor Services

Trust Advisor Services

Trust Advisor Services

Many Special Needs Trusts are funded with personal injury litigation proceeds intended to pay for the future medical care of their beneficiary.  These trusts are often established to protect the beneficiary’s access to government benefits such as Medicaid.  However, what’s often overlooked is the requirement to consider Medicare’s interest in the trust.  Simply placing settlement funds within a trust does not satisfy Medicare Secondary Payer (MSP) compliance.  Non-compliance with the obligations to consider and protect Medicare’s interests in a settlement can jeopardize a beneficiary’s future Medicare benefits*.

Medivest Medicare Set-Aside Trust Advisor Services provides trustees confidence they are in compliance with the intent of the MSP Statute, and beneficiaries peace of mind their Medicare benefits will be protected.  This service is designed to take the burden away from the trustee by advising the trust on the administration of all the medical funds, including the Medicare Set-Aside (the funds earmarked for future Medicare allowable, injury related medical care).  It’s like having your own department of MSP compliance experts!

*At a minimum for those benefits related to the settled injury, or in some cases, until reimbursement issues are fully resolved, all Medicare benefits could be denied/delayed.

How Medicare Set-Aside Trust Advisor Services works:

Claims Analysis and Re-Pricing
Medivest will review every medical claim. Each will be separated into Medicare allowable and non-Medicare allowable expenses, and a determination will be made about each expense’s relation to the beneficiary’s injury. The claim will be re-priced to the applicable fee schedule and forwarded to you. All you need to do is attach payment to the explanation of benefits we’ll provide, and send it to the beneficiary’s medical provider.
Professional Support for Medical Providers
There’s no need for you to explain the Medicare Secondary Payer statute to medical providers, or negotiate price. Medivest will interface with medical providers, durable medical equipment and supply vendors, and pharmacies to make sure they understand how they’re being paid, and when they can expect payment.
Coordination of Benefits with the Beneficiary’s other Insurance Policies
Medivest will coordinate benefits with other insurers, such as private group health plans, Medicaid, and Medicare to make sure payment obligations are addressed properly.
MSP Compliance Reporting
Medivest will handle the requisite annual reporting to Medicare, and coordinate with them when and if the Medicare Set-Aside funds exhaust, making Medicare primary.
Pharmacy and DME Discount Network Access
MSP rules require prescriptions to be priced at or below the Redbook Average Wholesale Price (AWP). Medivest Medicare Set-Aside Trust Advisor Services will go further by providing the beneficiary access to its pharmacy and durable medical equipment network. This means savings on prescriptions well below the requisite AWP price, and highly competitive DME pricing. The result is considerable savings to the beneficiary.
You’re In Control
With Medivest’s Medicare Set-Aside Trust Advisor Services, the trust funds remain with you. That means you retain authority over every penny.

Let Medivest help you manage the medical portion of your trusts.

Contact Medivest today at 1-877-725-2467 x3, or email us at