WCSMA Self-Administration Assistance Program

Why do you need a "SAAP" for your "Workers' Compensation Medicare Set-Aside" (WCMSA)?

So you can: remain Medicare eligible, extend the life of your WCMSA funds and avoid paying out-of-pocket for Medicare copayments, deductibles and coinsurance!

If you had a structured settlement, all it takes is one hospital admission or a new prescription that was not projected for your future medical care and “wham,” your annual annuity is temporarily exhausted. When this happens, Medicare becomes the primary payer and according to Medicare guidelines, you are responsible for charges and treatment/supplies Medicare does not cover. What’s more, only Medicare-approved providers can bill Medicare and many medical suppliers and some physicians are not Medicare-approved. If you are self-administering your WCMSA funds, it’s up to you to handle all of these details!

Here is what Fidelity Fiduciary Company (FFC) can do for you, at NO COST TO YOU (our fees are paid by the WC carrier and are separate from the money you receive from them at settlement): We can administer your Prescriptions and Medical Supplies/Durable Medical Equipment.

  1. 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 apt to remain Medicare-compliant/Medicare-eligible throughout your life expectancy.
  2. You will receive your medical settlement funds and FFC will receive your pharmacy/DME settlement funds. We then invest your funds in an interest-bearing bank account and enroll you in our Pharmacy and Durable Medical Equipment (DME) Discount Program. This insures we only pay what is WC injury-related, Medicare-covered and below retail price. We will do this throughout your normal life expectancy. If your prescriptions change, this could be a huge savings for your WCMSA account and could prevent you having to pay out-of-pocket.
  3. 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 Rx/DME