General

What is the Center for Disability Rights Community Supplemental Needs Pooled Trust?

Individuals with disabilities who have too much money to qualify for Medicaid can put the extra money into a special bank account called a Supplemental Needs Pooled Trust. The money put into this account is not counted as income or resources for people with disabilities applying for Medicaid and can be used for supplemental needs above and beyond what is covered by Medicaid.

The Center for Disability Rights, Inc. (CDR), a non-profit organization, has set up such a bank account, maintained by Canandaigua National Bank & Trust, allowing individuals with disabilities to qualify for Medicaid and still have the financial resources needed to live in the community. Although the funds are pooled together in the Trust, CDR maintains individual sub-accounts for each member.

Are trusts legal?

Yes. Trusts are used by many people as a tool to reduce assets so that they may apply for Medicaid. Supplemental Needs Pooled Trusts have been used for about 25 years. In 1993, Congress specifically authorized the use of Supplemental Needs Trusts. Although individual trusts are only available to those under the age of 65, CDR’s Community Supplemental Needs Pooled Trust, authorized by 42 U.S.C. § 1396p (d)(4)(C), is available for people with disabilities of any age.

It seems odd that I would need to open a trust account and send you my money to then pay my bills. Can’t I just pay my bills directly?

It may seem unnecessary, but those are the rules that the government set up for these trusts. If you didn’t use the trust, those funds would have to pay for medical expenses for you to qualify for Medicaid. By putting this money in the trust, you get to use it for your personal benefit and still qualify for Medicaid. Although it may not seem like it makes sense, it is a tool to keep you at home and independent.

I heard that only people with developmental disabilities can use a trust. Is that true?

No. Although Supplemental Needs Trusts have been much more widely publicized within the developmental disability community as a tool to assist parents with getting Medicaid benefits for their developmentally disabled children, you can have any type of qualifying disability as long as your doctor has evaluated your condition and determined that you are disabled and you follow the Determination of Disability process.

Who would benefit by joining the trust?

Several different groups of people could benefit from joining this trust:

• People who “spend down” to qualify for Medicaid. Some people “spend down” to get Medicaid services such as home care or other community-based long term services and supports because their monthly income or assets are over the limits established by the government to get Medicaid. Each month, these individuals need to pay for some of their own medical expenses and submit receipts or give the county a check. Instead, these individuals could put that money into CDR’s Community Supplemental Needs Pooled Trust. Once the money is in the trust, it becomes exempt which means that it is not counted by Medicaid. The person becomes eligible for Medicaid benefits and services while still being able to use the money put into the trust for their personal benefit.
• Families caring for a child with a developmental disability can use the trust for estate planning purposes. They can put money in the trust and use it for their child’s future expenses. These resources will not prevent the child from qualifying for Medicaid.
• People over the age of 65 can use this trust instead of paying a Medicaid “spend down.” A Pooled trust is the only trust option for disabled persons over the age of 65 who have income or assets which are above the established Medicaid limits. It is an ideal solution for seniors who need long term services and supports, but wouldn’t be able to maintain their home with the money Medicaid would allow them to keep. The trust allows them to do both!
• People with brain injury or spinal cord injury – in fact any type of disability – who need Medicaid services to live in the community may benefit from joining the trust. This option allows folks to get the services they need without spending down virtually all of their money.
• People with HIV/AIDS or other medical conditions that may have high medical expenses may benefit by joining our pooled trust. They can put money in the trust and use it for their future expenses. These resources will not prevent them from qualifying for Medicaid.
• People on transplant list may be required to have Medicaid. The pooled trust allows them to qualify yet still pay any expenses not covered by Medicaid that they may have for the indeterminate period of time they are on the waiting list.

Are there any other advantages to being in this Pooled Trust?

Yes, as a member of the Pooled Trust the consumer is eligible to enroll in the Medicare Savings Program (MSP). This program assists the eligible consumer with paying for Medicare premiums, co-insurance, and deductibles. It is to the consumer’s best interest to enroll in a MSP because it saves them a monthly amount of $135.50 (in 2019) increasing their income which allows for payment for additional approved items.