1. MEDICAID ELIGIBILTY – Trusts, Promissory Notes, and LLC’s

2. Background Medicaid was originally part of 1960’s Great Society programs, along with Medicare and amendments to the Social Security Program Goal -- help the poor, elderly, and disabled Payback trusts -- created in 1993 to further this goal by allowing specific types of trusts that will not affect a beneficiary’s eligibility MEDICAID TRUSTS The Good, the Bad, and the Ugly

3. TYPES OF TRUSTS  Revocable  Living  Testamentary  Charitable  Irrevocable  Medicaid

4. Special Needs Trusts - The Good Creation Distributions Termination

5. Pooled Trusts – The Bad Creation Distributions Termination

6. Medical Assistance Income Trusts – The Ugly Creation Distributions Termination

7. Trust Administration in Iowa Referrals to DHS Approval Process Monitoring by Trust Program Termination at Death and Estate Recovery Benefits of a Medicaid Trust Program

8. Conclusion Effects on eligibility Need for rules and guidance

9. Promissory Notes and LLC’s in Medicaid Eligibility Travis Smith Assistant General Counsel Oklahoma Department of Human Services P.O. Box 25352 OKC, OK 73125 (405) 521-3638