Medicaid Supplemental Needs Trusts

Filling a Growing Space

By Dr. David Edward Marcinko; MBA, CPHQ™, CMP™

By Thomas A. Muldowney; MSFS, CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ™, CMP™dhimc-book2

Some states now allow family and friends (not the individual Medicaid applicant) of a disabled individual to establish a trust, either inter vivos or testamentary, that permits distributions of income or principal without jeopardizing the beneficiary’s right to Medicaid, Supplemental Security Income, and other public benefits.

Of Trusts and Trustees

The trust allows the trustee discretion to make payments directly to the provider of goods and services for the beneficiary’s benefit to supplement public benefits. The beneficiary may be a disabled person of any age who is expected to have long-term needs (medical, social, psychological, and so on).

The Limits

There are no limits on the amount of income or principal that otherwise may be expended on the beneficiary’s behalf. After the disabled beneficiary’s death, the state has no right of recovery against the funds remaining in the trust because the trust was funded with the assets of someone other than the disabled beneficiary. The trust is truly supplemental; its assets may pay for lifestyle comforts, but not for any expense covered under Medicaid.

Assessment

Thus, a son or daughter could establish such a trust to provide additional comforts to a parent in a Medicaid-paid nursing home without jeopardizing that parent’s right to continuing Medicaid support. Upon the death of the parent, the trust remainder can then revert to the child.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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