| (Section 1917(d) of the Social
Security Act; U.S. Code Reference 42 U.S.C.1396p(d))
Where an individual, his or her spouse, or
anyone acting on the individual's behalf, establishes a trust using at least
some of the individual's funds, that trust can be considered available to
the individual for purposes of determining eligibility for Medicaid.
In determining whether the trust is
available, no consideration is given to the purpose of the trust, the
trustee's discretion in administering the trust, use restrictions in the
trust, exculpatory clauses, or restrictions on distributions.
How a trust is treated depends to some
extent on what type of trust it is; for example, whether it is revocable or
irrevocable, and what specific requirements and conditions the trust
contains. In general, however, payments actually made to or for the benefit
of the individual are treated as income to the individual. Amounts that
could be paid to or for the benefit of the individual, but are not, are
treated as available resources. Amounts that could be paid to or for the
benefit of the individual, but are paid to someone else, are treated as
transfers of assets for less than fair market value. Amounts that cannot, in
any way, be paid to or for the benefit of the individual are also treated as
transfers of assets for less than fair market value.
Certain trusts are not counted as being
available to the individual. They are:
Trusts established by a parent,
grandparent, guardian, or court for the benefit of an individual who is
disabled and under the age of 65, using the individual's own funds.
Trusts established by a disabled
individual, parent, grandparent, guardian, or court for the disabled
individual, using the individual's own funds, where the trust is made up of
pooled funds and managed by a non-profit organization for the sole benefit
of each individual included in the trust.
Trusts composed only of pension, Social
Security, and other income of the individual, in States which make
individuals eligible for institutional care under a special income level,
but do not cover institutional care for the medically needy.
In all of the above instances, the trust
must provide that the State receives any funds, up to the amount of Medicaid
benefits paid on behalf of the individual, remaining in the trust when the
individual dies.
A trust will not be counted as available to
the individual where the State determines that counting the trust would work
an undue hardship.
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