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Medicaid Spend Down and Special Needs Trust

In order for an individual to be eligible for Medicaid, there are financial standards that need to be met. Many Medicaid applicants will have to spend some of their assets in order to meet Medicaid’s financial threshold. There are a few excludable resources that are exempt from the Medicaid Spend down. These assets can be kept by the Medicaid applicant and will not impede Medicaid eligibility. An individual’s personal possessions, a prepaid irrevocable funeral trust and a special needs trust for a disabled child, are just a few excludable resources when applying for Medicaid.

Today we will discuss utilizing a special needs trust with the excess “spend-down” money. When a Medicaid applicant has a disabled child a special needs trust allows the transference of assets from a parent to the child without jeopardizing the child’s government benefits.

Special needs trusts are also referred to as “supplemental care trust” these trusts supplement the disabled child’s supplemental security insurance (SSI) and Medicaid benefits. The money in a special need trust may only be used for specific items or services. The trust is meant to supplement, and not pay for basics such as food and shelter. Some things that may be purchased through a special needs trust include:

  • Home modifications to assist the disabled,
  • Medical treatments and equipment not already covered by government assistance programs.
  • Education and recreation equipment
  • Computers
  • Musical instruments
  • Sports equipment
  • Travel expenses
  • Prepaid funeral

When a parent creates a special needs trust for a disabled child, He/ She chooses a trustee. A trustee is an individual or institution who manages the assets in the trust. The trustee’s responsibility is to follow the terms and guidelines outlined in the trust as well as transferring the funds from the trust to the beneficiary or disabled child. A trustee can be a family member, attorney, bank or anyone that one chooses to assign as a trustee.

The trust is an excludable resource for government benefits for both the parent applying for adult Medicaid and the disabled child receiving SSI and Medicaid benefits. The trust restricts the beneficiary (or Disabled child) and parent access to the assets in the trust. Only the trustee would have accessibility to the funds and therefore it’s considered an unattainable asset for both the parent and disabled child. It is for this reason that it will not impede Medicaid eligibility for either.

One should consult with a competent elder care attorney for advise on if and when such planning strategies are advisable.