The Oklahoma Bar Journal February 2024

Bound class. 31 The asset limits are the same as for someone living in a nursing home – $2,000 in “countable” assets. 32 The “countable” income limit is $6,833 per month the same, but any income above $2,742 is not available to the SoonerCare recipient. 33 The income and assets of a parent of a minor do not count when deter mining eligibility. 34 These waiver programs used to have a years-long waiting list, but thanks to a large additional appropriation by the Legislature, the waiting list is being eliminated. The In-Home Supports Waiver provides services costing up to $29,914 for adults and $19,283 for minors. 35 There are many types of services available. 36 The most com mon is a habilitation training specialist (HTS), who helps the disabled person learn life skills. The Community Waiver, sometimes known as the “big waiver,” provides the same services without a cost cap. 37 The Community Waiver also has residential services available, with three waiver participants living in a home where the room mates receive services 24/7. 38

a third-party trust do not count against the SSI and Medicaid asset limits. It is income if the trustee gives the beneficiary cash or pays directly for food or shelter. As with (d)(4)(A) or (d)(4)(C) trusts, it is in the beneficiary’s best interest to pay for income items with their SSI payment and for the trustee to pay for items that are not income. An advantage of a third-party trust is that when the beneficiary dies, the remaining assets can be directed to family members or charities. ABLE Accounts An ABLE account can be estab lished by or for a person who became disabled before age 26. 20 In 2026, the age goes up to 46. 21 Up to $18,000 of the disabled person’s money, or money belonging to another, can be put into the account each year. If the ABLE account accu mulates money and, when added with all other countable assets, is more than $100,000, SSI will be suspended until the total is less than $100,000. 22 Medicaid has no such cap. An ABLE account can pay for anything that is for the sole benefit of the beneficiary and – unlike a (d)(4)(A), (d)(4)(C) or third-party trust – can pay for food and shelter without it counting as income for SSI and Medicaid. 23 Therefore, it is good to put a paragraph in a (d)(4)(A) trust that allows the trust to fund an ABLE account. You will have to talk to the nonprofit operating a (d)(4) (C) trust to see if it is possible for the trust to fund an ABLE account. Like a (d)(4)(A) trust, when the beneficiary dies, any money left in an ABLE account goes to repay Medicaid. 24 MEDICAID Medicaid is a federally authorized and partially federally funded health insurance program that provides

services to certain categories of peo ple who are unable to afford health care. 25 Although shorter, the Medicaid Act will remind you of the Internal Revenue Code in its complexity. Medicaid is known as SoonerCare in Oklahoma. OHCA is the des ignated Medicaid agency, which contracts with DHS to determine eligibility for people who are over 65 or who have been determined to be disabled by the SSA. 26 Medicaid has asset and income limits. It mostly, but not entirely, uses SSI rules to determine income and assets. There are about 55 ways to be eligible for SoonerCare, with five broad categories. The category we are interested in is Aged, Blind and Disabled (ABD). 27 Within ABD are a couple of dozen ways to be eligible. The most common categories for people with disabilities are: SSI recipients: An individual who receives at least $1 of SSI per month is eligible for Medicaid. 28 Disabled, living in the Medicaid if their countable income is up to $1,215 per month, and countable assets are up to $9,090. 29 The income and assets of parents living in the home with a minor are counted when determining the minor’s eligibility, except when the minor is receiving services through a develop mental disability waiver. 30 Developmental disability community: A person with disabilities not living in an institution is eligible for

OTHER STRATEGIES

Inheritance A person with disabilities who receives SSI and/or Medicaid should never directly inherit money. If they inherit, the only way they can stay on benefits is to establish a (d)(4)(A) or (d) (4)(C) trust, which will almost never be able to be passed on to family or charity when the beneficiary dies.

waivers: DHS operates two programs for people who are developmentally dis abled and have intellectual disabilities and who are not members of the Homeward

Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff.

FEBRUARY 2024 | 19

THE OKLAHOMA BAR JOURNAL