When a person suffers a physical injury and is a Medicare beneficiary or has a reasonable expectation of becoming one within 30 months, Medicare coverage for injury-related care can be lost post settlement without a set aside.
Set asides are difficult to self-administer which is what led to the creation of the Settlement Solutions Medicare Set Aside Pooled Trust (SSMSAPT). Most Medicare set aside administrators offer custodial arrangements which put a client’s money at risk in the event of insolvency of the administrator. The SSMSAPT is different since it is a trust arrangement that creates a fiduciary duty on the part of the trustee of the trust. This means it can go in perpetuity even in the event the trustee can no longer serve as a new one is appointed. Also, the SSMSAPT gives the trust beneficiary an experienced set aside administrator who can adjudicate bills and manage the intricacies of reporting to Medicare.
A pooled trust must be established by a non-profit. SSMSAPT was established by The Foundation for Those With Special Needs, Inc. (FTWSN). FTWSN, the Trustee of the SSMSAPT, is a non-profit 5O1(c)(3) dedicated to helping those with special needs and supporting other charitable organizations that protect and promote the civil justice system. The Foundation was created as a way to give back to the civil justice system, support those that need its protections, and serve as a trustee for the pooled trust.
Rising Financial Solutions is the MSA administrator of the SSMSAPT. Rising combines mastery in Medicare compliance with sound financial management and a powerful medical cost containment program. Rising’s expertise is used in determining the appropriate reimbursement in medical charges to extend MSA funds to their fullest potential, protect Medicare’s interests, and extinguish liability for settlement parties.
SSMSAPT’s fees are by far one of the lowest in the country. Fees for MSAs with $25,OOO or more in future prescription drug expenses are as follows:
MSA Allocation of $49,999.99 or Less:
One Time Fee: $75O.OO - Annual Fee: Free*
MSA Allocation of $5O,OOO to $249,999.99:
One Time Fee: $1,35O.OO - Annual Fee: Free*
MSA Allocation of $25O,OOO to $499,999.99:
One Time Fee: $2,OOO.OO - Annual Fee: Free*
MSA Allocation of $5OO,OOO to $999,999.99:
One Time Fee: $3,OOO.OO - Annual Fee: Free*
MSA Allocation of $1,OOO,OOO.OO or more:
One Time Fee: $5,OOO.OO - Annual Fee: Free*
* For allocations with less than $25,000 in future prescription drugs, an annual fee of $300.00 will apply. The annual fee must be paid by an annuity that is purchased at the time of settlement and made payable to the Foundation for Those With Special Needs, Inc.