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How long does it usually take the cms to decide a medicare set aside amount? Does that money have to be used strictly for medica

Brooklyn, NY |

my insurance company offered to settle with me $52,000 plus they will pay medical. I havent been to any of my doctors in a year and a half because they told me it was nothing else that could be done for me, I have reached maximum improvement. My lawyer told me that the insurance company was waiting to hear back from cms to determine how much money they will set aside for future use. I just wanted to know how long this usually takes, my lawyer told me not long

Attorney Answers 1


  1. Your lawyer's experience is far different from mine. Working with CMS is one of the most time consuming and frustrating things our practice does when settling personal injury claims. They have strong statutory protection when it comes to recovering money from third party cases - they can collect from the lawyer and from the beneficiary - and as a result they do not hurry for any one or any reason. At least that has been my experience along with all of the other attorneys who I have discussed this issue with in Pennsylvania.

    If your attorney can get this done in less than 3-6 months depending on the complexity of your case he is doing a great job.

    For specific legal advice, an attorney needs to know the specific facts and circumstances of a case. This answer does not constitute legal advice nor does it form an attorney/client relationship.