The challenges of being disabled can be exasperated when you or a loved one is faced with the inability to qualify for needed Medicaid benefits. These benefits can be crucial, especially for those seeking long-term home care in New York. As part of the State’s comprehensive home care program, approximately 100,000 disabled or elderly individuals are able to stay at home while meeting their health needs. However, doing so requires eligibility to receive Medicaid.
For some disabled persons, not qualifying for Medicaid home care benefits has to do with earning more income than the program allows. However, by joining a Pooled Trust to qualify for these benefits, these individuals can realize the advantages of long-term home health care.
How can I qualify for Medicaid if I exceed income limits?
Disabled New York residents must qualify for Medicaid to remain at home while receiving health care benefits. But to be eligible, certain income limits cannot be exceeded. In other words, these individuals may not earn “excess income,” which is earned income over the established Medicaid limit.
In these cases, joining a Pooled Trust is necessary to help those who are disabled receive government assistance. This is especially true when family members (the household) exceed the limits and cannot afford to pay out of pocket for a loved one’s home care.
By joining the trust, members can qualify financially and maintain eligibility for Medicaid home care benefits. The Pooled Trust helps to preserve income with the ability to use the excess income deposited monthly to pay bills and expenses not covered by Medicaid. These expenses can include living expenses, medical bills, rent, home modifications, food, utilities, and personal needs.
Without participation in the trust, those seeking Medicaid benefits would otherwise have to “spend down” their extra earnings to be eligible. By joining the trust, disabled residents have access to their surplus earnings through the trust to help meet living expenses they would not be able to afford.
What is a Pooled Trust?
Sometimes referred to as a Medicaid-qualifying trust, a Pooled Trust is regulated by both Federal, Section 1917(D)(4)(C), and state laws. The Pooled Trust is a unique type of trust that is managed by a nonprofit organization to help seniors, and people with disabilities receive long-term medical care while staying in their homes. This trust pools together and manages the income of many members whose funds are held in subaccounts.
Who is eligible to join a Pooled Trust?
Disabled New York residents (as defined by Social Security Law), regardless of age, can participate in a Pooled Trust. By doing so, their excess income is not considered in the determination of eligibility for government benefits.
Those who seek Community Medicaid with Long-Term Care must be legally disabled individuals certified by the State of New York or Social Security Administration to participate in a pooled income trust.
New York residents who are disabled and use a pooled income trust for home care eligibility requirements must have documentation and a State evaluation that proves their disability.
What are the benefits of joining a Pooled Trust?
For disabled persons and seniors, joining a Pooled Trust has several advantages including gaining peace of mind when you need it most. Here are some reasons to consider participating in a Pooled Trust:
- Qualify for Medicaid benefits. Individuals with disabilities can qualify and maintain their eligibility for Medicaid home care benefits by depositing their excess income into a Pooled Trust.
- Receive At-Home Care. When you join a Pool Trust, you’re able to gain and maintain eligibility for government benefits needed to pay for home health care.
- Protect Funds by Avoiding Spend Down. Participating in a Pooled Trust can provide financial security and preserve the quality of life by helping to protect funds from having to be spent down quickly as required for Medicaid eligibility.
- Maintain the Ability to Pay Other Bills. Although you qualify for home care benefits, other living expenses still exist and need to be paid regularly. The Pooled Trust manages your extra earnings monthly to pay your approved bills.
- High-Quality Funds Management. Pooled trusts are protected by law and managed by nonprofit organizations that put your unique needs first. They provide professional funds management and oversight to ensure accuracy and accountability.
- Customization to Meet Member Needs. Although pooled together, the trust is designed to accommodate the unique needs, goals, and individual preferences of each member.
If you or your loved one is a resident of New York and the concept of joining a Pooled Trust is new or confusing to you, seek an experienced trust provider like KTS pooled trust or consult an attorney who specializes in pooled trusts and/or elderly law.
Source: KTSTrust.org
