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Title 8: Medicaid Page 56 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Trusts Revised July 10, 2026 Evaluating a Trust

Beneficiary Chart Use this chart if a trust exists for the benefit of the member. (The member is the beneficiary.) The member does not hold legal title to the trust property but does have an equitable ownership interest in it.

Treatment of Resources in a Trust When determining eligibility, first review the trust to see if it is accessible. If the principal and income are accessible, count the amounts toward the resource limits and use them when determining eligibility, client participation, and spenddown. For eligibility purposes, there is no requirement that the beneficiary of a trust take legal action to attempt to gain access to the trust principal. Was the trust established after August 10, 1993? Is the beneficiary also the grantor?

NO Apply appropriate non- MAGI-related or MAGI-related policy. YES

NO For trusts established on or before August 10, 1993, apply Medicaid qualifying trust policies.

YES For trusts established after August 10, 1993, evaluate the trust under the revocable or irrevocable policies unless it is:  A special needs trust for persons under 65 years old,  A medical assistance income trust, or  A special needs trust (no age limit). Treat according to the policies found in this chapter.