The questions people ask us, answered plainly.

It is a good idea when your surplus is more than a small amount and you need Medicaid home care. The downsides, plainly: no cash out, money left at the end stays with the trust or the state, there are fees, and you must deposit every month. We wrote them all on one page, and we say on the call if it is not right for you.

Yes. 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. When you join, Medicaid's own reviewers check your trust paperwork and approve it before your budget changes. Nothing about it is hidden. The state explains the rules on its trusts information page at health.ny.gov.

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.

It is for a New Yorker who needs Medicaid, usually for home care, whose monthly income is over the Medicaid limit, and who is found disabled by Social Security or New York State. Most people who need help at home meet that. If it is not right for you, we say so on the first call, and the call is free.

$1,856 a month for one person and $2,509 for a couple. The part of your income above the limit is your surplus. It changes every January, and Medicaid sets your exact number. Estimate your surplus here.

Yes. The 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 together with the trust application.

Both incomes count unless the spouse who does not need Medicaid signs a spousal refusal. Then only your income is counted. Call us and we go through it with you.

There is no rule. Our monthly fee is 10% of the deposit and never less than $35, so with a very small surplus it can make more sense to pay Medicaid directly. We tell you honestly which is better for you on the call.

You can pay your surplus to Medicaid every month instead. Medicaid then covers only the months you paid, and the money is gone. In the trust the same money pays your rent, utilities and other bills.

No. The trust pays the companies you owe and loads your Visa card for purchases. It cannot send money to you or to your checking account, and the card cannot be used to take out cash. Please know this before you join.

Money left in your account stays with the trust or goes to the state for Medicaid costs. It cannot be paid back to your family, your estate or a bank account. That is why the account is meant to be used for your bills each month, not saved up.

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.

Your Social Security award letter and any pension statements, your Medicaid number and letters if you have them, the name of anyone helping with your Medicaid application, your doctor's name, and the bank account the monthly deposit will come from.

The joinder agreement (the paper that makes you a member), an authorization for us to handle your account, a direct debit form for the monthly deposit, and the fee schedule. For Medicaid there is also a doctor's form and a short questionnaire, which we help you complete.

The person named in your power of attorney or guardianship papers signs for you, and a copy of those papers goes with the application. If a guardianship is still in court, we prepare everything and hold it until the court date. The signature is notarized or, inside the five boroughs of New York City, witnessed by two people.

Yes. Most of it happens by phone, email and mail with the family member who is helping. The signing is arranged where your parent is, including a home visit. You can also see the account online once it is open.

A doctor who knows your condition. Your own doctor can complete it. If that is hard to arrange, we set up a telehealth visit to complete it, so you do not have to find an appointment.

Yes. We do applications by phone, by mail, in person at our office, or with a home visit.

Yes. We prepare the packet, send it to your Medicaid plan or to your county's Medicaid office, and follow up until it is approved. The one thing we do not do is take over your Medicaid application itself; we work alongside whoever is doing it.

We file once your first deposit has cleared. Medicaid's review can take up to 90 days, and we follow up along the way. We tell you where things stand at each step, and we do not promise a date for a decision Medicaid makes.

A monthly fee of 10% of your deposit, at least $35 and at most $300, taken from the deposit once it clears. $150 a year, starting the year after your first deposit. A one-time enrollment fee, usually $300, sometimes lower or waived, and waived when you switch from another pooled trust. The fees, with examples.

Usually it builds up from your first deposits and is taken once, in full. You can also pay it separately by check or money order, or as a one-time amount added to your first deposit. Your card is not loaded until it has been taken.

By direct debit from your own bank account, on a day you pick when you join (for example the 3rd, 10th, 15th or 25th). It never runs on a weekend or a bank holiday. The first deposit can also be made by check.

The deposit is reversed, your bank's returned-payment fee (about $53) is added, and your card is paused. We tell you right away. Your next deposit covers the missed one, and we take no fees until it clears. The best protection is to have the money in the account before the deposit day, and to call us before the day if it will not be.

Bills in your name from a company: rent, mortgage, co-op maintenance, utilities, cell phone and cable, car costs for a car in your name, current credit card charges, medical costs Medicaid does not cover, and other expenses with a dated bill or quote in your name. If you are not sure about a bill, ask us before you count on it.

Payments to you or your family, gifts, donations, alcohol, tobacco, firearms, cash advances, bank overdraft fees, expenses after death, bills Medicaid already covers, and legal fees for a criminal case. Rent paid to a spouse is also not allowed. The trustee decides each bill.

No. The trust pays the company directly and cannot reimburse you, your spouse or a joint account. Send us the bill before you pay it, and we pay it from your account.

It must be for something within the last 90 days, in your own name, with the bill, invoice or quote attached.

Yes. A bill that is the same amount to the same company every month is set up once and paid every month without a new request.

Bills are processed the day your deposit lands. A check prints the same afternoon if the bill came in that morning, otherwise the next day. The company then receives it by mail, often a week or more later, so send bills early. Bills are always paid before money goes on the card.

No. We pay exactly the amount you ask for. If the account cannot cover it in full, we tell you so you can decide whether to wait, lower it or pay it another way.

Yes. Money left at the end of the month stays in your account for later bills. Remember it cannot be paid to you or to your family, so plan to use it.

Send us the Medicaid letter the day it arrives. We change the monthly deposit to match. If Medicaid raised the amount starting in an earlier month, there is a catch-up for those months, which we take as one separate deposit only after you agree and the money is there. If Medicaid lowered it, the lower amount starts with the next deposit.

Medicaid covers a month only if that month's surplus went into the trust. A missed or short month can be read as non-payment, and Medicaid can be made inactive. If a month will be a problem, tell us before the deposit day, not after.

Through a verification of deposit, a statement from the trust listing each month's deposit. Medicaid asks for it when you apply and at every yearly review. We provide it once the deposit has cleared, and you can download it from your portal.

A prepaid Visa card loaded from your trust account. Use it anywhere Visa is accepted, in a store or online, except for things the trust cannot pay for: alcohol, tobacco, firearms, gifts, donations. It cannot be used to take out cash.

Each month, after our fees and your bills are paid, what is left can go on the card. You can choose to have the remainder loaded, a fixed amount, or a load only when you ask. The first load happens after the enrollment fee has been taken.

Call us. A lost card is replaced and the balance moved to the new one. A card is paused when a deposit is returned, and works again once the deposit clears. A card about to expire is renewed about two months before.

Yes, if they are named on your paperwork as your representative. Tell us who helps you when you join and we talk to them like we talk to you.

Yes. The online portal shows the balance, bills and card, and your family can send bills by photo and ask questions. See what the portal does.

Ask us and we send it by mail or email. The portal shows the same transactions any time.

Call us as soon as plans change. The rules are different in each case, and telling us early keeps your Medicaid in order.

Yes. Call us and we explain what happens in your case, what Medicaid will need, and how the balance is handled. Remember that money left in the account cannot be paid back to you.

Yes. We handle the switch and waive our enrollment fee, and the only rule is not to miss a deposit during the move. How switching works.

Call or text 718-701-7777, Monday to Thursday 9 AM to 5 PM, Friday 9 AM to 12 PM in winter and 1 PM in summer, Eastern. Press 2 for intake, 3 for account management. Or email info@ecstrust.org. A person picks up, and it costs nothing.