Distinguishing the Different Medicaid Programs

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Medicaid is an assistance program. It serves disabled and low-income people of every age. A small co-payment is sometimes required. Medicaid is a federal program and its eligibility criteria varies from state to state.

A Special Needs Trust preserves Supplemental Security Income and Medicaid. Eligibility is based on disability and income.

Why consider a Special Needs Trust?

Medicaid Coverage + Tax Free SSI + IHSS may be worth thousands of dollars every month!

Disability-Based Medicaid

(Also Know as a needs-based or traditional medicaid)

CLIENT MUST USE SPECIAL NEEDS TRUST OR SPEND THE MONEY WITHIN THE SAME CALENDAR MONTH TO PRESERVE BENEFITS

  • Permanently disabled & unable to work
  • Only Income Test Applies in California
  • Income and Asset Test Applies - Needs based
  • Supplemental Security Income (SSI) recipients
  • In-Home Support Services (IHSS) recipients
  • Home and community-based waiver participants
  • Long Term Care Facility residents

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Income Based Medicaid

(Also Known as Expanded/MAGI Medicaid)

DOES NOT NEED A SPECIAL NEEDS TRUST (SNT)

  • Able to work & income is below 138% of the Federal Poverty Level (FPL)
  • MAGI Medicaid based on the household income
  • Assets are not counted towards eligibility
  • Parents / caretakers relatives
  • Pregnant women

CLIENT CAN TAKE SETTLEMENT PROCEEDS WITHOUT LOSING BENEFITS

The Difference Between Medicaid and Medicare Programs

Please note that your client may be on both programs

Medicaid

Low-income families and children
People with disabilities
Pregnant women
Seniors (65+)

68.6 million Americans

Primary, specialty, acute, custodial and long-term care

No premiums or copayments for lowest-income beneficiaries

Oversight by CMS

Medicare

Seniors (65+)
People who work enough work quarters to qualify
People of any age with End-Stage
Renal Disease (ESRD)

58.1 million Americans

Primary, specialty, skilled, and acute care

Beneficiaries must pay premiums and deductibles

Federal government through CM

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