MEDICAID ELIGIBILTY Trusts Promissory Notes and LLCs MEDICAID

MEDICAID ELIGIBILTY – Trusts, Promissory Notes, and LLC’s

MEDICAID TRUSTS The Good, the Bad, and the Ugly Background l Medicaid was originally part of 1960’s Great Society programs, along with Medicare and amendments to the Social Security Program l Goal -- help the poor, elderly, and disabled l Payback trusts -- created in 1993 to further this goal by allowing specific types of trusts that will not affect a beneficiary’s eligibility

TYPES OF TRUSTS v Revocable v Living v Testamentary v Charitable v Irrevocable v Medicaid

Special Needs Trusts - The Good l. Creation l. Distributions l. Termination

Pooled Trusts – The Bad l. Creation l. Distributions l. Termination

Medical Assistance Income Trusts – The Ugly l. Creation l. Distributions l. Termination

Trust Administration in Iowa l l l Referrals to DHS Approval Process Monitoring by Trust Program Termination at Death and Estate Recovery Benefits of a Medicaid Trust Program

Conclusion l l Effects on eligibility Need for rules and guidance

Promissory Notes and LLC’s in Medicaid Eligibility Travis Smith Assistant General Counsel Oklahoma Department of Human Services P. O. Box 25352 OKC, OK 73125 (405) 521 -3638