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Title 8: Medicaid Page 58 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Trusts Revised September 13, 2024 Treatment of Resources in a Trust

Testamentary and Inter Vivos Trusts Medicaid Qualifying Trust (set up before 8/10/93) Irrevocable Trust (set up after 8/10/93) Revocable Trust (set up after 8/10/93) Availability of principal and income Discretionary: Principal and income are not necessarily available to the beneficiary. Principal and income available to the beneficiary for basic needs is countable as resources and income when determining eligibility, client participation, and spenddown. Principal and income available for nonbasic needs only are not countable as resources and income. Discretionary: The maximum amount that may be made available by the trustee under the terms of the trust, assuming the trustee exercises full discretion in the distribution of the income and principal is countable in determining eligibility, client participation, and spenddown. See Transfer of Assets for any principal or income not available to the grantor. The principal and income are considered available and countable to the extent they could be made available, under any circumstances or for any purpose, according to the terms of the trust. See Transfer of Assets for any principal or income not available to the grantor. Principal and income are available and countable to the beneficiary when determining eligibility, client participation, and spenddown. See Transfer of Assets Any payments from the trust not for the benefit of the client are assets transferred for less than fair market value.