Where a workers compensation claim settled prior to January 1, 2006, can the injured party use the Medicare Set-aside funds to pay for prescription drug expenses related to the workers compensation injury?
A69. No. If the workers’ compensation settlement included an allocation for non-Medicare covered medical and/or prescription drug expenses, the injured party must exhaust those funds prior to billing Medicare for prescription drugs (assuming the injured party has opted for Part D coverage. However, the injured party does not have to transfer those funds to an existing Medicare Set-aside account or include them in the annual Medicare Set-aside accounting. After exhausting these funds, if the injured party enrolls in a Part D plan, Medicare may be billed for prescription drug expenses related to the workers’ compensation injury, assuming that the injured party does not have any other coverage primary to Medicare.
Related Questions
- Where a workers compensation claim settled prior to January 1, 2006, can the injured party use the Medicare Set-aside funds to pay for prescription drug expenses related to the workers= compensation injury?
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