Do you have a Medicaid spend down requirement? A spend down requirement occurs when Medicaid determines that your income is too high to qualify for Medicaid funding and that in order to qualify you would have to spend a certain amount yourself on medical bills before being able to qualify. A person of any age with a disability can potentially eliminate the requirement by participating in a pooled income trust. In a pooled trust you contribute funds and the trust pays certain expenses directly, such as rent or mortgage and utilities. The funds being paid directly from the trust are not then considered income for Medicaid purposes and can eliminate a spend down requirement. Essentially the trust protects your excess income as defined by Medicaid and allows you to qualify for coverage.
In order to start, you would sign up for the trust. The start up and administration fees are relatively low compared to other types of trusts. You will have to establish a disability, however a finding by Medicaid or the Social Security Administration will be sufficient to establish it. You would then submit your bills to the trust for payment. The trusts may be a good option for certain people, particularly given the high cost of living in New York. As with all estate planning, trusts should be evaluated as part of a larger, comprehensive plan. There are various types of trusts available and an experienced estate planning or elder law attorney can explain the various options as well as the benefits of each.