A pooled income trust is the right choice for many New Yorkers who need Medicaid home care and have income over the limit. It is not right for everyone. These are the things people wish someone had told them first.
The downsides
- No cash outThe trust pays the companies you owe and loads your Visa card. It cannot send money to you or to your bank account, and the card cannot take out cash.
- Money left at the end does not come backWhen a member passes away, what is left in the account stays with the trust or goes to the state for Medicaid costs. It is not paid to the family. What happens after death ›
- There are fees10% of each deposit, at least $35 and at most $300 a month; $150 a year from the second year; usually $300 once to join, waived when you switch from another trust. The full fee list ›
- Every month, on timeMedicaid covers a month only if that month's surplus went into the trust. A missed or short month can be read as non-payment. If a month will be a problem, tell us before the deposit day.
- Bills go by mailWe process bills the day your deposit lands and print the check the same or next day, but the company receives it by mail, often a week or more later. Send bills early.
- It is for people found disabledThe law allows a pooled trust for people who are disabled under Social Security or New York State rules. Needing care at home usually meets that; if it has not been decided yet, we start that paperwork with you.
- Medicaid's review takes timeWe file once your first deposit clears. Medicaid's review can take up to 90 days. We follow up, and we do not promise a date for a decision Medicaid makes.
What you get
- You keep your home careMedicaid counts you as under the limit, so your coverage continues.
- Your money pays your billsRent, utilities, phone, copays, groceries on the card. Without the trust, the same money goes to Medicaid and is gone.
- We do the paperworkThe application with you, at home if you like, the doctor's form by telehealth, the filing with Medicaid, and the follow-up until it is approved.
- A card and an account onlineA Visa card for purchases and a portal where you or your family see the balance, the bills and the statements.
It is not a loophole
Pooled income trusts are written into federal law (since 1993) and New York State law, which let a nonprofit run one trust for many people who are disabled. New York Medicaid knows them well: when you join, Medicaid's own reviewers check your trust paperwork and approve it before your budget changes. The state explains the rules on its trusts information page.
When it is worth it, and when it is not
Our monthly fee is never less than $35. With a very small surplus it can make more sense to pay Medicaid directly, and we say so on the call. With a surplus of a few hundred dollars or more, the trust usually wins: most of the money pays your own bills instead of leaving. The two choices, side by side ›
Not sure which is better for you? Ask. A person picks up, and we tell you honestly.
Common questions
Can I leave the trust?
Yes. Call us and we explain what happens in your case, what Medicaid will need, and how the balance is handled. Money left in the account cannot be paid back to you.
Do I pay taxes on the money in the trust?
Your income is taxed the same way it was before you joined. The deposit is money you already received, such as Social Security or a pension, and moving it into your trust account does not change your own tax return. The trust does not send you a tax bill. For your own situation, ask the person who does your taxes.
Do I give up control of my money?
The money stays in your name and is used only for you. You decide which bills to send. We pay them to the company you owe, and the trustee approves each payment. You cannot receive it as cash.