Is a Medicare Set-Aside a lien by the carrier?

[Danabell]

Timothy Belt Wrote:I don't know about your state, but in PA the right to subrogation by the WC carrier against a third party recovery is absolute. This would potentially include not only past benefits but the WC settlement amount. In PA, the parties may reduce or eliminate this lien in the WC settlement itself, but language to that affect would have to be in the settlement agreement. Therefore, I would start by asking the WC lawyer whether the lien was compromised or waived, and if so, where is this reflected in the agreement.

Thank you everyone for the responses. The lien was not waived in the lump sum agreement. I understand that I have to pay back what, rightfully, is owed to WC. I just don't know if the medicare set-aside is rightfully owed. If it is not lienable (is that a word?) then they can't charge me for that. I haven't read anything where the medicare set-aside paid by the carrier had to be paid back. I also did not find anything that said it didn't. I am really confused and so is my atty! Best Regards, Danabell

[Timothy Belt]

My guess, and this is a guess, is that if a lump sum distribution for future medical would be part of the lien, the Medicare set-aside would also be part of the lien. The only difference that I can see is that the set-aside is for future medical that would otherwise be payable by Medicare. It is still a payment by the carrier as a result of your work injury.

[Danabell]

Timothy Belt Wrote:My guess, and this is a guess, is that if a lump sum distribution for future medical would be part of the lien, the Medicare set-aside would also be part of the lien. The only difference that I can see is that the set-aside is for future medical that would otherwise be payable by Medicare. It is still a payment by the carrier as a result of your work injury.

That is what I am thinking - that since the set-aside was funded by the carrier, it is a lien. However, my attorney thinks that I would be paying twice and it may not be lien. His reasoning is that the set-aside is money earmarked for services that medicare would pay. So essentially, I am using this money to pay back medicare. Then. if I have to pay back the workers' comp. carrier for the set-aside, I would be making 2 payments ( to medicare and the carrier). I see both sides to the argument but I don't know which reasoning is correct. Best Regards and thanks for your help, Danabell