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Title 8: Medicaid Page 67 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Trusts Revised September 13, 2024 Medicaid Qualifying Trusts

Mrs. P, an NF resident, has social security income of $245. She also has civil service income of $310. She has a Medicaid qualifying trust that could pay $120 a month for expenses if she needed the money. Eligibility for Medicaid is determined as follows: $ 120.00 245.00 +310.00 $ 675.00 Trust income Social Security Income Civil Service income To compare to the 300% income limit (Medicaid cap) Her income used to determine client participation is $675.00. Trusts Established After August 10, 1993 When the client or someone acting on the client’s behalf created a trust using the client’s assets after August 10, 1993, determine whether the client is a beneficiary of the trust. If the client is not a beneficiary, investigate the trust as a transfer of assets. If the client is a beneficiary, treatment of the trust depends on whether the trust is revocable or irrevocable. Three special kinds of irrevocable trusts (Medical Assistance Income Trusts (MAITs) and two special needs trusts) also receive different treatment. Revocable Trusts Legal reference: 441 IAC 75.24(2)“a” When an applicant or member establishes a revocable trust established after August 10, 1993, the principal of the trust is an available resource. Payments from the trust to or for the benefit of the applicant or member (as beneficiary) are countable income to the applicant or member in the period of intended use when determining income eligibility for Medicaid. Any payments from the trust other than those made to or for the benefit of the applicant or member (beneficiary) are assets transferred for less than fair market value.