1. ABLE Accounts and Medicaid Payback

2. What’s an ABLE Account?
New tax-free savings tool for qualified individuals with disabilities
Doesn’t affect eligibility for means-tested government benefits
Similar to 529 College Savings Plan

3. Handling Funds Left Upon Account Holder’s Death
Outstanding Qualified Disability Expenses (QDEs) must first be paid
State Medicaid may claim payback for services delivered since opening of account
Includes both medical and waiver services
Source of account funds—account holder or others─makes no difference

4. State Discretion
Individuals and families should research payback policy in state(s) where Medicaid services have been received
Theoretically possible that a given state’s Medicaid program will not seek payback from account holders resident in that state
If account holder moves out of non-payback state, lien will likely be applied by new state of residence

5. SNTs and Medicaid Payback
Federal law requires Medicaid payback from 1st party SNTs and certain pooled SNTs
Created with funds belonging to beneficiary
Pooled trusts combine sub-accounts for many beneficiaries
Payback covers Medicaid services performed throughout beneficiary’s life
3rd party SNTs not subject to payback
Funded by anyone other than beneficiary

6. Strategy to Consider Establish 3rd party SNT tied to ABLE account
Distribute trust funds to ABLE account, as needed
Minimizes likelihood of lien
Reaps benefits of ABLE accounts