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How to use a pooled SNT to eliminate the Medicaid spend-down.

Views: 34719
Posted: 01 Aug, 2008
by David Silva (New York Legal Assistance Group)
Updated: 16 Aug, 2017
by Valerie Bogart (New York Legal Assistance Group)

This memo explains how to use a Pooled Supplemental Needs Trust to eliminate the Medicaid spend-down (updated July 2017)

Note that new State forms (486T and 1151) were released in October 2012 for proving disability, as needed for approval of a Supplemental Needs Trust.  See this article for links to the new forms.  

Also note that NYSARC revised its joinder agreement and certain procedures in June 2012.  Links to these revised forms are on NYSARC website, links  in this article .

Also, while an agent appointed by a valid Power of Attorney may execute the joinder agreement on behalf of an applicant, HRA in July 2017 issued a policy saying that POA's executed after Sept. 1, 2009 must include a Substantial Gift Rider (SGR) along with the POA form.  HRA will reject the trust as invalid without this rider.  Under state law, a POA must be executed at the same time as the SGR.  Therefore, if there is no SGR, either  a new  POA and SGR must be executed together as new or the applicant, if s/he has capacity, can sign a new joinder agreement directly. At least one pooled trust -- CDR-- will amend an existing trust if provided with the re-executed documents.  Then that re-approved trust should be sent to HRA with the request for approval.   HRA has not yet said if such amended trusts will be approved.

Also see these new tools to help clients who want to enroll in pooled trusts, developed by NYLAG:

This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.


Attached files
file Pooled Trust Readiness Checklist.pdf (158 kb)
file Pooled Income Trust Contribution Worksheet.xls (42 kb)
file SNTShort_2017 (July 2017).pdf (690 kb)

Also read
document List of Pooled SNTs in New York State
document Advocate's Outline on Supplemental Needs Trusts
document Step-by-step guide to enrolling in a pooled income trust for Medicaid spend-down
document Medicare Savings Programs (MSP) in New York
document Legal Authorities Relating to Supplemental Needs Trusts
document Medicaid Disability Determinations - NYS Forms & Procedures (with updated forms July 2012)
document Applying for Medicaid Personal Care or CDPAP Services in New York City - 2016 Changes
document Special Income Standard for Housing Expenses: If Discharged from Nursing Homes or Adult Homes and Enroll in MLTC Plan
document Know Your Rights: NYLAG Webinars on Medicare and Medicaid -

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List of Pooled SNTs in New York State     Legal Authorities Relating to Supplemental Needs Trusts

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