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

Learn about the different types of trusts that can impact Medicaid eligibility, including revocable, living, testamentary, charitable, irrevocable, and Medicaid special needs trusts. Discover the implications of pooled trusts and medical assistance income trusts, as well as the trust administration process in Iowa. Additionally, gain insights into the role of promissory notes and LLC's in Medicaid eligibility.

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

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

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

  3. TYPES OF TRUSTS • Revocable • Living • Testamentary • Charitable • Irrevocable • Medicaid

  4. Special Needs Trusts - The Good • Creation • Distributions • Termination

  5. Pooled Trusts – The Bad • Creation • Distributions • Termination

  6. Medical Assistance Income Trusts – The Ugly • Creation • Distributions • Termination

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

  8. Conclusion • Effects on eligibility • Need for rules and guidance

  9. 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

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