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How Can I Keep My Loved One At-Home? A Look at Pooled Income Trusts

As elder law attorneys, we frequently meet with family members frustrated by the cost of long-term health care. Many of our clients wish to remain at home but are misinformed as to their options.

A Pooled Income Trust

A Pooled Income Trust is a great vehicle to facilitate the goals of applying for Community (home care) Medicaid and remaining in your own home. This Trust has no age limitation and no pay-back provision. It is established and managed by not-for-profit associations along with a trust company as trustee. The beneficiary of the Trust is the Medicaid applicant/disabled person. The Trust has numerous beneficiaries (hence the term “pooled trust”) so a sub-account is created specifically for each one. During the lifetime of the beneficiary the contributed funds can be used for his/her sole benefit. Upon the beneficiary’s death, any funds remaining in the trust is paid to the not-for-profit agency to help foster its objectives.

Community Medicaid

Community Medicaid has income limitations. For the year 2019, an applicant is permitted to retain $879.00 per month of his/her own income. Due to rising living expenses, the imposition of this limitation can make it impossible to remain in your own home. Without the Pooled Income Trust, any overage of income must be paid to the care agency rendering services as a contribution toward the cost of care. However, by simply participating in a Pooled Income Trust, the applicant may send any excess income to the pooled trust company along with qualifying expenses to preserve that income. Some examples of qualifying expenses are rent, mortgage payments, real estate taxes, utilities, clothing, and private pay care services.

An Example

For example – Mrs. Smith is 80 years old and was diagnosed with dementia. Her income is comprised of social security retirement benefits and a pension in the aggregate sum of $2,400 per month. She wishes to remain at home but has increased medical needs. She relies on the entirety of her income to pay her household bills and daily expenses. By applying for Community Medicaid, she will receive in-home health care services, but she is only permitted to keep $879.00 of her monthly income. She can “join” a Pooled Income Trust and by contributing her overage of $1,521.00 each month ($2,400 – $879 = $1,521) along with invoices for her personal needs and household expenses up to the total amount (less a typically nominal fee paid monthly to the trustee). Now Mrs. Smith can receive the care she needs at home without compromising the balance of her income.

Although the Trust companies charge administrative fees associated with enrollment, generally, the benefits far exceed the costs.

NYS Approved Pooled Income Trust Companies

For a full list of NYS approved Pooled Income Trust Companies, please visit

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