Page 63

Title 8: Medicaid Page 59 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) Use in Medicaid and State Supplemen- tary Assistance Count amounts available according to the terms of the trust. Amounts that count toward FIP, SSI, or SSA cash payments are not used in determining Medicaid eligibility. Any available principal or income counts toward resource and income limits. If not available, see transfer of asset policy. Count principle and income as available. Procedure: Refer trusts and conservatorships, including MAITS, for review by the Medicaid Trust Program. Even if clarification is not needed for Medicaid eligibility purposes, the referral is needed for proper tracking of Medicaid payback trusts. A referral should also be made when requested by Trust Program staff even if there is no Medicaid case. Referring trusts and conservatorships is also needed to:  Clarify how the terms of the trust impact eligibility;  Make Trust Program staff aware when an inaccessible trust is held by an active member, a trustee is not abiding by the terms of the trust, or the trustee has the authority to use the principal of the trust for medical expenses but has not done so. Make the referral for initial review by sending form 470-5132, Clarification Request (located in WISE) to trust@dhs.state.ia.us. In the clarification request:  Identify the client by name (if the trust beneficiary is a child, provide the child’s name, not the case name), social security number, date of birth and state identification number. (This information is essential because program staff do not have access to the ABC system, Online Narrative, or electronic case files.)  Provide all the case numbers of the files where you want the response placed.  Identify relationship of client to the grantor or trustor.