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Pooled Medicaid Payback Trust
How Does a Pooled Medicaid Payback Trust Work?  

If a resident of Ohio is disabled and receives money through an inheritance, gift, personal injury settlement, back-payments from Social Security, or even the lottery, their options are limited if they want to preserve their government benefits, such as Supplemental Security Income (SSI) and Medicaid.

A Pooled Medicaid Payback Trust allows an individual with a disability to place money into a trust account and receive distributions from the trust account for supplemental services in a way that does not jeopardize eligibility for government benefits.

A Pooled Medicaid Payback Trust is created using money from an Ohio resident with a disability, know as the Beneficiary. Once a trust account is established, the Designated Advocate makes requests for distributions from the trust account for supplemental services for the Beneficiary. To ensure that government benefits are not jeopardized, Community Fund Management Foundation acts as the Trust Advisor and convenes a committee to review distribution requests. Provided the distribution does not cause any risk to or loss of the Beneficiary's government benefits, money is distributed from the trust account by the Trustee, Fifth Third Bank, Northeastern Ohio.

Pooled Medicaid Payback Trust - Beneficiary
The trust account is established for the benefit of an individual with a disability, known as the Beneficiary. The Beneficiary must be an individual with a disability and a resident of Ohio.
Pooled Medicaid Payback Trust - Designated Advocate


A Designated Advocate is also named when a Pooled Medicaid Payback Trust is established. The designated advocate can be a relative, friend, an organization, or the individual with a disability, if he or she has the capacity to do so.

The person establishing the trust account names a Designated Advocate. It is important to select a Designated Advocate who understands the needs of the Beneficiary and who will represent the best interests of the Beneficiary in a responsible and trustworthy manner.

The Designated Advocate works with the Trust Advisor, communicating the needs of the Beneficiary of the trust account and providing information and documentation about the government benefits and supplemental services for the Beneficiary.

Pooled Medicaid Payback Trust - Trust Advisor

 

As the Trust Advisor, CFMF works with the Designated Advocate and reviews all requests for distribution from the trust account to ensure that the Beneficiary's government benefits are not jeopardized. A Review Committee evaluates all requests for distributions to make sure the distributions do not jeopardize benefits that have been applied for or are currently being received by the Beneficiary.

To offset administration costs, there is a fee charged by CFMF for the creation of a Pooled Medicaid Payback Trust. There is also a minimal annual management fee.

Pooled Medicaid Payback Trust - Trustee
As Trustee, Fifth Third Bank, Northeastern Ohio, invests the assets of the Pooled Medicaid Payback Trust and makes distributions from the trust account. Funds in the trust account are invested in mutual funds administered by the bank and interest is earned on the investments.

The Trustee, Fifth Third Bank, Northeastern Ohio, does not charge a trust account management fee.

What happens to money remaining in a Pooled Medicaid Payback Trust when the Beneficiary dies?

Upon the death of the Beneficiary, the funds remaining in the trust account may be left in the trust account and the income earned paid to Community Fund Management Foundation. Or the funds can be used to pay back the Ohio Department of Job and Family Services for assistance provided through the Medicaid program to the Beneficiary, and named individuals can receive the funds remaining, if any, after the pay back to the state. This election is made when the trust account is established.

Funds going to Community Fund Management Foundation are used to support its charitable work of administering trusts and educating the community about the availability of trust for individuals with disabilities.

It is also possible to establish a Pooled Medicaid Payback Trust with Community Fund Management Foundation and one of our partnership organizations. Funds left in a partnership trust account after the Beneficiary's death can be used by the partnership organization for supplemental services for other individuals with disabilities affiliated with the partnership organization.
Reviewing and Completing Pooled Medicaid Payback Trust Documents
  Community Fund Management Foundation does not provide legal advice or assistance to establish the Pooled Medicaid Payback Trust. A licensed attorney must review the trust documents and sign them.



 
Enjoying Your Lottery Winnings

Winning the lottery should be a something to enjoy. Unfortunately, for individuals with a disability who receive government benefits, such a stroke of luck can jeopardize their benefits.

The Pooled Medicaid Payback Trust can help by allowing the individual to set aside such winnings, or funds from any source that an individual with a disability may receive, so that they can be used by the individual in a way that enriches his or her life and does not jeopardize government benefits.

Pooled Medicaid Payback Trusts

Pooled Medicaid Payback Trusts are authorized under Federal law (42 U.S.C. §1396p(d)(4)(C) as amended effective October 1, 1993). The law allows the creation of pooled trusts for persons with disabilities (as defined by Social Security criteria) of any age as long as the individual was disabled prior to the age of 65.

To qualify for and remain eligible for governmental benefits (SSI/Medicaid), a person with a disability cannot own resources in excess of the program's eligibility limits and cannot have income in excess of the Federal benefit rate. If either of the maximum levels is exceeded through work income, inheritance, a personal injury settlement, or other sources, SSI eligibility and the accompanying Medicaid eligibility can be lost.

Assets in a trust are not considered a resource if the person with a disability has no ability to revoke the trust or control any distributions from it. A Pooled Medicaid Payback Trust is designed so that the beneficiary does not have the ability to terminate the trust or to control distributions; therefore, the trust is not regarded as a resource for the purposes of SSI or Medicaid eligibility.

A Pooled Medicaid Payback Trust must
Be established and managed by a non-profit corporation
Maintain a separate Sub-Account for each Beneficiary of the trust, but for the purposes of investment and management of the funds, the trust pools these accounts
Have Sub-Accounts that can be composed of the Beneficiary's own assets and are established by a parent, grandparent or legal guardian of the person with a disability; the person with a disability himself or herself; or by a Court, solely for the benefit of the individual with a disability.

Upon the death of the Beneficiary, to the extent the amounts remaining in the Sub-Account are not retained by the trust, the funds must be used to pay the state an amount equal to the total amount of assistance paid on behalf of the Beneficiary under the state Medicaid plan

 
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