Why you need a “SAAP” for your “Workers’ Compensation Medicare Set-Aside”

  • Remain Medicare eligible
  • Extend the life of your WCMSA funds
  • Avoid paying out-of-pocket for Medicare co-payments, deductibles and coinsurance

If you have a structured settlement, all it takes is one costly hospital stay or the addition of expensive medications to temporarily exhaust your funds, triggering Medicare as the primary payer, and potentially leaving you responsible for treatment/supplies Medicare does not cover. In addition, only Medicare-approved providers can bill Medicare; many medical suppliers and some physicians are not Medicare-approved. If you are self-administering your WCMSA funds, you will likely need some assistance to navigate this potentially complex system. We can help you by providing the following:

Here is what Fidelity Fiduciary Company (FFC) can do for you: We can provide as little or as much help as you need, including administering your prescriptions and medical supplies.

  • Administer all your WC related medical needs providing you deep discounts on RX and medical supply prices.
  • Administer just your RX program providing you with cost-saving measures from our bill reduction partners.
  • Enroll in FFC Bill Pay Program wherein you keep your settlement funds while FFC assists you by paying your discounted medical bills. For a nominal fee, we will mail you Medicare’s Self-Administration Kit and answer any questions you may have about how to fulfill your administrative duties to Medicare for one year. This will help you develop a credible relationship with Medicare from the very beginning. Once you are experienced, you are more prone to remain Medicare-compliant/Medicare-eligible throughout your life expectancy.
  • A more advanced option that incurs no additional cost to you involves you maintaining your medical settlement funds, but directing pharmacy/DME funds to FFC so the funds can be invested in an interest-bearing bank account. You will then be enrolled in our pharmacy/DME settlement program.. A final option involves FFC setting up an ACH account (ACH form required) for payment of WC related medical bills. A $500 yearly fee made payable to FFC covers this specific program. These programs ensure that the only bills that will be reduced, processed and paid are the ones that are WC injury related, Medicare covered, and below retail pricing.
  • Lastly, but very importantly, we will provide you with an Annual Financial Statement itemizing our payments and your savings throughout the year. You will need this figure to complete the Attestation form you must send to Medicare annually. It is also excellent documentation should Medicare ever question your expenditures.