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389 (07/2026) Chapter 2:Eligibility • Section 5: Financial eligibility • It specifies that the state will receive all funds remaining in the trust upon the death of the individual up to the amount of medical benefits provided on behalf of the individual. Income cap trusts established between Oct. 1, 1993, and March 31, 1995 This applies to trusts established between Oct. 1, 1993, and March 31, 1995, for the individual’s benefit and containing only their current and accumulated income. The accumulated amount remaining in the trust shall be paid directly to the state upon the death of the individual up to the amount of medical benefits provided on behalf of the individual. The trust is the total income in excess of the income standard for OSIPM. The remaining income not deposited into the trust shall be available for the following deductions in the order they appear prior to applying the patient liability: • Personal needs allowance • Community spouse monthly maintenance needs allowance • Medicare and other private medical insurance premiums, and • Other incurred medical. Income cap trusts established on or after April 1, 1995 These trusts are established for the benefit of the individual whose income is above 300 percent of the full SSI standard and containing the current and accumulated income of the individual. The accumulated amount remaining in the trust shall be paid directly to the state upon the individual’s death, up to the amount of medical assistance provided on their behalf. The trust contains all of the individual’s income. The income deposited into the trust shall be distributed monthly in the following order: • Personal needs allowance and applicable room and board standard • Reasonable administrative costs of the trust, not to exceed a total of $50 per month, including the following:
Trustee fees Note: If the individual is the trustee, (exception approved by Policy due to literally not having anyone else to manage the trust), it is not reasonable to allow a trustee fee. That fee is meant for hiring another person to manage the trust, and any such income would raise the individual’s income, which would have to be run through the income cap trust.
A reserve for administrative fees and costs of the trust, including bank service charges, copy charges, postage, accounting and tax preparation fees, future legal expenses, and income taxes attributable to trust income, and
Conservatorship and guardianship fees and costs. • Community spouse and family monthly maintenance needs allowance • Medicare and other private medical insurance premiums • Other incurred medical care costs as allowed under 461-160-0030 and 461-160-0055 • Contributions to reserves or payments for child support, alimony and income taxes • Monthly contributions to reserves or payments for the purchase of an irrevocable burial plan with a maximum value of $5,000. The individual may use one of the following for a burial fund: