Set Aside Specialists, LLC

Specializing in Medicare Set-Aside Allocations

Below you will find a referral form and release forms you can download. 

We can work with you to provide a cost projection without signed release forms.  However, a signed Medicare release form is necessary in order to submit a MSA to CMS for approval.  A signed Social Security release form is required to confirm SSDI and Medicare status.
 
 

Document Library

NameDescription
DocumentMSA Referral Form(In the event you prefer to complete a hard copy and fax it to us)
DocumentSocial Security Release Form(Used to confirm SSDI and Medicare Status)
DocumentMedicare Release (Used to submit documents to CMS)