BENEFICIARIES WHO RECEIVE MEDI-CAL AND NOT SSI
If a beneficiary receives Medi-Cal (California’s Medicaid Program), and not Supplemental Security Income (SSI), CPT, as Trustee, can pay for a certain portion or percentage of the beneficiary’s request to purchase food, shelter, utilities, or other In-Kind Support Maintenance (ISM) items without impacting Medi-Cal eligibility. Other items that are not considered as In-Kind Support Maintenance, can be paid in full without jeopardizing Medi-Cal eligibility.
Kevin Urbatsch, National Director of Academy of Special Needs Planners (ASNP), and author of Administering the California Special Needs Trust: A Guide for Assisting a Person with a Disability as Trustee of a Special Needs Trust (2011), states, “If the SNT trustee pays the entire amount of need for these items (ISM items), DHCS (Department of Health Care Services) will count that as Medi-Cal in kind-income which would create an increase in the share-of-cost owed by beneficiary.”
What is Share-of-Cost?
Share-of-Cost is the amount an individual agrees to and needs to apply for before Medi-Cal starts to pay. Share-of Cost is a set amount based on how much an individual makes.
Sandra, a beneficiary, who receives Medi-Cal, but not Supplemental Security Income (SSI) submits a request to have CPT, as Trustee, to pay for her groceries, rent, and utilities which totals to $1500 a month. If CPT, as Trustee, pays the full amount of $1500, it would count as in-kind income by Medi-Cal. In turn, this would increase Sandra’s Medi-Cal Share-of-Cost by $1500. When that happens that means that Sandra would have to pay $1500 for her health care services before Medi-Cal would start to cover medical services.
Know Your State’s Medicaid Program: https://www.medicaid.gov/