Life Care Plans

Early Mediation Education Provide materials at least 14 days prior to mediation and mail demand with attachments and provide organized CD of evidence Prepare notebooks prior to the mediation for all persons at mediation (PowerPoint presentation, medical, Medicare Set Aside, Life Care Plans, TrOOP Analysis, CD of evidence, etc.)

Issues (see written materials) Medicare Set Aside (MSA) Getting physicians to properly address future medical care and cost issues Life Care Plan TrOOP Analysis Cost of administering the Medicare Set Aside Trust Annuities

What are the potential costs over and above what MSA covers to provide equivalent care to claimant who merely keeps his significant lifetime medical care case open under workers’ compensation?

This estimated True Out of Pocket (TrOOP) expense analysis was prepared after reviewing medical records and conducting a client phone interview. The TrOOP is to be used for educational purposes during mediation and settlement negotiations only, and is otherwise confidential attorney work product. This analysis is based on review of the PMSI Settlement Solutions MSA-dated These calculations and inclusion of medicare items/descriptions are based on published standards at time of review, Based on information obtained from the Medicare website, this assessment is an estimation and can be amended at any time based on new medicare guidelines and review of additional medical records. MSA Total Proposed: $ 134, TrOOP Analysis: Monthly Yearly Life 1. Part A Expenses $ - $ - $ - 2. Part B Premium $ $ 1, $ 33, Part D Premium $ $ $ 8, Medigap $ $ 2, $ 73, Donut Hole (DH) $ $ 4, $ 132, Non Covered Rx (OTC) $ $ 2, $ 68, Non Covered Medicals $ $ 2, $ 65, Non Covered Transportation $ - $ - $ - TrOOP costs of future services which are reasonably anticipated to accrue but not covered by the MSA= $ 380, TrOOP costs of future services which are reasonably anticipated to accrue + MSA amount = $ 515,169.79

Why settle with MSA and Life Care Plan? Cost savings to pay at Medicare rates rather than WC fee schedule rates Save ongoing claims administrative time and costs on significant lifetime medical cases Only way to close files in certain situations Can buy annuities to get medical care funded at a cost effective rate