Protecting Medicaid Eligibility With a Pooled Trust

If you’re working with a client in a personal injury case are you prepared to protect their Medicaid eligibility? Not only does Medicaid impose technical requirements, they impose financial requirements with strict asset and income limits. Basically, if your client wins a settlement from their personal injury case that same settlement could potentially jeopardize their Medicaid benefits, even if it’s a small amount.

The best way to protect your client’s Medicaid eligibility is through a special needs trust or a cost effective-option such as a Medicaid pooled trust. This way, their Medicaid will not be at risk. For the sake of this article, we’ll focus on pooled trusts for Medicaid purposes.

Can My Client Give Away Assets to Meet Medicaid Requirements?

Your client cannot transfer their assets to anyone in order to meet Medicaid requirements. In fact, Medicaid will impose a penalty on anyone that transfers assets without receiving fair value in return. The safest way to protect your client is to have funds transferred into a Medicaid pooled trust where they will not incur a penalty period and the funds within the trust will not be counted as your client’s assets.

Who Manages Pooled Trusts?

The income and assets within a Medicaid pooled trust are managed by nonprofit organizations and are paid back to your client over time. These same funds can be used to pay for your client’s “supplemental needs” which are expenses that improve their quality of life but which aren’t covered by Medicaid. Upon your client’s death, the remaining funds are paid out based on state regulations and the requirements of the trust.

Preserving Your Client’s Access to Benefits

You may have won your client a large settlement case, but don’t celebrate too soon. If that settlement causes your client to lose their long-term access to health insurance you could have a malpractice problem on your hands. Since your client’s loss of governmental benefits can greatly affect their health and long-term care, you want to make sure that you help them protect their settlement money as well as preserve their Medicaid benefits.

If you are unfamiliar with the pooled trust process, you will need a professional that understands disability requirements, state rules that govern pooled trusts, and how to properly administered a Medicaid pooled trust. Synergy Settlement Solutions can make the process much smoother for you and your client. We’re a phone call away.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

TESTIMONIALS

"I have used Synergy to resolve tough Medicare lien and set aside issues. There is no other practice that comes close to the quality of their work. I highly recommend them and they are a must for the substantial, tough cases."

Mark R. Hanson
LaBovick Law Group

"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

Ready to schedule a consultation?

The Synergy Settlements team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

Request Consultation
WordPress Image Lightbox