Page 2

Appendix A-6 Page 2 of 2

Revised 10/01/2025

9. Payments for recreational opportunities, family visits, or visits to friends for the beneficiary must be reasonable under the circumstances. Payments for family members to visit the beneficiary may be made if the visit is for the purpose of ensuring the safety and well-being of the beneficiary.

10. Payments for non-medical expenses such as radios, televisions, audio or video equipment, computer equipment or electronic devices and/or equipment must be made for the primary benefit of the beneficiary and reasonable under the circumstances and considering the size of the trust.

11. The pre-need payment of burial expenses, the purchase of pre-need burial contracts or the payment of burial insurance premiums are allowable, but if such arrangements have not been made prior to the passing of the beneficiary, they must not be paid until after reimbursement has been made to Medicaid.

12. Payments for the following items will produce In Kind Support and Maintenance (ISM) for the beneficiary: rent, mortgage payments (including property insurance required by the mortgage holder), real property taxes (less any tax rebate/credit), heating fuel, gas, electricity, water, sewer, garbage removal. ISM is considered income and may affect eligibility for Medicaid-only beneficiaries or reduce SSI benefits.

13. Distributions from the trust directly to the beneficiary or to the beneficiary’s bank account will be considered income to the beneficiary in the month in which the distribution is made. Direct distributions must be reported and may result in loss of coverage for Medicaid-only beneficiaries or reduction and possible loss of SSI benefits.

If there are questions as to whether a proposed expense will be allowed by Medicaid, the Trustee should call Division of Medicaid, Office of Eligibility, at 601-359-6120 to determine Medicaid’s position prior to making payment.

As trustee of the ______________________ Special Needs Trust, I acknowledge receipt of these guidelines. I understand that my failure to follow these guidelines may affect the Medicaid eligibility of the beneficiary of the trust.

__________________________________

(Trustee’s Signature)

__________________________________

(Trustee’s name printed)

__________________________________

(Date signed)