New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 215 - MEDICAID ELIGIBILITY - SUPPLEMENT SECURITY INCOME (SSI) METHODOLOGY › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.215.500.16 - TRUSTS

Current through Register Vol. 35, No. 13, July 16, 2024
In some instances, an applicant/recipient with a trust can
				  be eligible for SSI cash benefits but not be automatically eligible for
				  medicaid. If the social security administration (SSA) determines that an SSI
				  recipient has a trust, SSI notifies the human services department (HSD) of the
				  existence of the trust. The recipient is then notified that the trust document
				  must be submitted to and reviewed by HSD before medicaid eligibility is
				  determined.
A.
Medicaid
				qualifying trusts:
A "medicaid-qualifying trust" (MQT) is a trust or
				similar legal device established prior to August 11, 1993, other than by will,
				by an applicant/recipient or spouse, under which the applicant/recipient may be
				the beneficiary of all or part of the payments from the trust. The distribution
				of trust payments is determined by one or more trustees who are permitted to
				exercise discretion with respect to the distribution of payments to the
				applicant/recipient. When the use of an attorney is solicited to establish a
				trust, the beneficiary of that trust is not exempt from the requirements of MQT
				provisions. Legal instruments such as trusts are almost always drafted by an
				attorney. It is the grantor him/herself who actually establishes of creates the
				trust when he/she signs or executes it.
(1)
Amount deemed available from an MQT:
The amount from an MQT that
				is deemed available to an applicant/recipient is the maximum amount that could
				be distributed to the applicant/ recipient, or for the care of the applicant/
				recipient, regardless of restrictions imposed by the trust on the allowable use
				of the funds. If, for example, the trustee can make payments to a health care
				provider for medical services, the applicant/recipient beneficiary is
				considered to be receiving benefits from the trust even though these benefits
				are not paid directly to the beneficiary. This provision applies regardless of
				whether the MQT was set up for the purpose of qualifying for medicaid or
				whether the trust is irrevocable.
(2)
Revocable trusts:
Revocable
				trusts that limit access to the assets held in trust must be dissolved and the
				assets spent down before eligibility can be established.
(3)
Beneficiary of trust lives in an
				ICF-MR:
If the beneficiary of a trust is an applicant/recipient who is
				mentally retarded and resides in an intermediate care facility for the mentally
				retarded (ICF-MR), that applicant/recipient's trust is not considered an MQT if
				the trust or trust decree was established prior to April 7, 1986, and is solely
				for the benefit of that applicant/recipient.
(4)
Treatment of SSI or social security
				lump sum payments:
SSI or social security lump sum payments for
				retroactive periods which are placed into an MQT do not qualify for the nine
				month exclusion from countable resources.