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My husband had an accident 3 + years ago and now is a paraplegic. The trauma was devastating. The first two years is a long hard story of what we went through, along with my & my daughter’s health being compromised so I will not go into details at this point. I was finally able to get him on Medicaid with help from an elder care attorney. She set up a special trust since his SS was over the limit for Medicaid. The trust takes out the over amount allowed & keeps it unless it is spent on his care. However, I just found out that it is only good up to $500. He is only $6 away from that. I cannot afford to pay for an aide without Medicaid & I am not able to take care of him myself. Does anyone know where I can go or what to do?


Thank you.

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This has got to be answered by a PA attorney. The easiest would be to contact the attorney who did the “Trust”. You cannot DIY this.

im going to guess that in the overwhelming and difficult times you, your hubs and fam has faced that the explanation that the atty did as to what was done has gotten muddled over time. You need to know precisely what type of Trust he has, what provides income to the Trust, what its limits or spending restrictions are. Those answers are on a PA attorney to explain to you.

But there are some things you can try to find out about in advance of meeting with an attorney: PA has 2 types of “SNT”: special needs trust AND supplemental needs trust. Same acronym but they are way different as to their restrictions on what they can pay for. Which one does he have? Or does he have a QDC aka a qualified Disability Trust?

Is the problem somehow that there is an increase in the $ he is paid and the Trust should have captured that increase and hasn’t? That’s atty work to do a fix.

Also which Medicaid program is he on? & which SSA program?
his Medicaid program eligibility tends to tie into what type of income he has.. so is he on SSI / supplemental security income? or is it SSDI / SS disability income based on work history? or did / has his SS payment category changed, like he’s moved to SS retirement income as he’s aged out of SSDI? You want to know all these details and have his Medicaid program info with you when you go to meet with the attorney.

Usually $ in a well done SNT should not effect any “at need” based program eligibility, like low income based Medicaid or SSI. That is why a SNT is done.
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Medicaid allows up to 15000 to be protected in a pre planned funeral trust. The $6 over per month (I assume it’s per month) could be placed in that trust.

https://www.medicaidplanningassistance.org/irrevocable-funeral-trust/
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igloo572 Apr 23, 2024
If you are referring to Irrevocable Funeral Trusts, 15K is not necessarily accurate. What precisely is allowed is dependent on what SSA program they are on AND which State Medicaid program they are on or are filing for, as well as the type of funeral & burial contract, e.g. if it is a preneed or a set aside; if $ for a “burial space” vs burial funds; if irrevocable vs revocable.

Some State allow a IFT of 15K, but some don’t. My State of LA has its max as 10K. UT is 7K. KS is $11,360. NYS does not allow IFT at all.

Also a State can have their own additional requirements done by the Trust, the insurance company or its underwriter to do any business in their State. Like TX has all this regulated by TX Dept of Banking and TX Dept of Insurance with all actions done under permits for both Divisions. TX requires a very detailed Good & Services document that must be included; contract must meet State of TX funeral directors & licensing standards as they have to have licensing with TX Funeral Services Commission.

If they are on SSI, its federal maximum is $1,500 for burial expenses UNLESS your State allows for a “liberalized” amount which varies by State. Liberalized tend to be 6K range. If it’s over, it counts as a resource and can make them SSI ineligible, which then poses issues for them being able to be eligible for Medicaid tied into SSI.

LSS You have to be - HAVE TO BE - very careful and do your research beforehand. It could end up quite problematic to just assume that you can blithely pay 15K and another 15K for your spouse and maybe even another 30K for 2 family members with that 60 large going into something irrevocable only to find out it’s not allowed. It’s your problem and not whomever sold you the product and got their nice commission on it.

FWIW all States - as far as I’m aware - require that the state is named residual beneficiary on IFTs.
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I’m so sorry that you are in this situation. I can’t imagine how hard that this must be for you.

I do not know what your next step should be. Stick around because there are several knowledgeable people who post regularly on this forum.

Wishing you and your husband all the best.
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You are so close to his qualifying that I cannot believe an appeal made with the extra information regarding your own health issues might not help? Is that elder law attorney you used originally still an option for you? I sure hope others are more informed than I and can give you added advice, and I wish you well. I hope you will update us.
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