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Medicaid Trusts and Special Needs Trusts

By David L. McGuffey, Certified Elder Law Attorney

This document is a work in progress. It may be used for research, but may not be reproduced in whole or in part without the express written permission of David L. McGuffey, except that no claim of copyright is made on materials quoted in this document. You may contact the author by email at david@mcguffey.net. Mr. McGuffey's mailing address is P.O. Box 2023, Dalton, Georgia 30722. Also, if you would like to contribute material to improve this outline, please contact Mr. McGuffey.

An Introduction to Trusts
Why Protect Assets?
What is Supplemental Security Income?
What is Medicaid?

Trust Formation and Structure
Creating the Trust
Trust Instrument and Essential Terms
The Trustee
Beneficiaries (of Trusts)
Purpose (of the Trust)
Revocation, Modification, Termination
Spendthrift Provisions
Discretion and Distribution Standards
Construction (Construing the Trust)

Funding the Trust
Funding, Generally

Trust Administration
Administration, generally
Administration and Investments
Investment Decision-making process
Income and Principal
Declaratory Judgment
Distributions, generally
Trust Ownership of a home
Distributions to family members

Medicaid Trust Rules
Trust Rules, generally
Self-Settled Trusts, generally
Third Party Trusts, generally
Income Only Trusts
Special Needs Trusts
Pooled Trusts
Sole Benefit Trusts
Funding Issues Associated with Special Needs Trusts
Distributions from Special Needs Trusts
SNT Accounting

More Coming soon......

Eligibility for Veteran's Aid and Attendance

Tax Issues


United States Supreme Court

  1. Alexander v. Choate, 469 U.S. 287 (1985)
  2. Great-West Life & Annuity Ins. Co. v. Knudson, 534 U.S. 204 (2002)
  3. Sereboff v. Mid-Atlantic Medical Services, Inc., 547 U.S. 356 (2006)


  1. Popowski v. Parrott, 2008 U.S. Dist. LEXIS 71615 (N.D. Ga)
  2. Robinson v. Lindsey, 184 Ga. 684 (1937)
  3. Blanchard v. Gilmore, 208 Ga. 846 (1952)
  4. McElrath v. Citizens & Southern Nat'l Bank, 229 Ga. 20 (1972)
  5. Henderson v. Collins, 245 Ga. 776 (1980)
  6. Avera v. Avera, 253 Ga. 16 (1984)
  7. Cooper v. Trust Company Bank, 257 Ga. 272 (1987)

First Circuit (and States) (Massachusetts, New Hampshire, Maine, Rhode Island and Puerto Rico)

  1. Doherty v. Director of the Office of Medicaid (Mass. App. Ct., Essex, No. 08-P-939, June 18, 2009)

Second Circuit (and States) (New York, Connecticut and Vermont)

  1. Wong v. Doar, 571 F.3d 247 (2009)
  2. Hecht v. Barnhart, 68 Fed. Appx. 244 (2nd Cir. 2003)
  3. Horowitz v. Barnhart, 29 Fed. Appx. 749 (2nd Cir. 2002)
  4. Calef v. Barnhart, 309 F. Supp. 2d 425 (E.D. NY 2004)
  5. Diamond v. City of New York, 2005 U.S. Dist. LEXIS 1494 (S.D. NY 2005)
  6. Matter of Kamp, 2005 NY Slip Op 25080 (Surrogate's Court, Case Number 82-594, February 22, 2005)
  7. Corcoran v. Dep't of Soc. Servs., 271 Conn. 679 (November 9, 2004)
  8. Ahern v. Thomas, 733 A. 2d 746 (Conn. 1999)
  9. Parkhurst v. Wilson-Coker, 82 Conn. App. 877 (May 10, 2004)
  10. Murphy v. Murphy, 2005 Conn. Super. LEXIS 1632 (FA000073829, June 14, 2005)

Third Circuit (and States) (Pennsylvania, New Jersey, Delaware and the Virgin Islands)

  1. Lewis v. Alexander, 685 F.3d 325 (3rd Cir. 2012)
  2. Lewis v. Alexander, 2011 U.S. Dist. LEXIS 95109 (E.D. Penn. 8/23/2011)
  3. Lewis v. Rendell, 501 F. Supp.2d 671 (E.D. Pa. 2007)
  4. In re Davis, 16 A.D.3d 414 (S.C. NJ, App. Div., 2nd Dep. March 7, 2005)
  5. J.S. v. Division of Medical Assistance and Health Services, Docket No. HMA-4896-06, 2006 NJ Agen LEXIS 1054 (N.J. 2006)
  6. Ricco v. Novitski, 2005 PA Super 121 (Docket No. No. 1007 MDA 2004, No. 1108 MDA 2004, April 5, 2005)

Fourth Circuit (and States) (Maryland, North Carolina, South Carolina, Virginia, and West Virginia)

Fifth Circuit (and States) (Louisiana, Mississippi and Texas)

Sixth Circuit (and States) (Kentucky, Michigan, Ohio and Tennessee)

Seventh Circuit (and States) (Illinois, Indiana and Wisconsin)

Eighth Circuit (and States) (Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota and South Dakota)

Ninth Circuit (and States) (Alaska, Arizona, California, Guam, Hawaii, Idaho, Montana, Nevada, Oregon, and Washington)

  1. Doe v. Hawkins, 2010 U.S. App. LEXIS 14923 (9th Cir. 7/20/2010)
  2. E.J. v. Mont. Contractors' Ass'n v. Healthcare Trust, 2011 U.S. App. LEXIS 18168 (9th Cir. 2011)
  3. Christoforo v. United States, 2011 U.S. Dist. LEXIS 100050 (W.D. Wash. 9/6/2011)
  4. Shewry v. Arnold, 125 Cal. App. 4th 186 (Cal. Ct. App., 2nd Div. December 22, 2004)
  5. In the Matter of the Estate of: Margaret O. Burns, 904 P.2d 301 (Wash. Appeals 1995)
  6. Redies v. Attys. Liab. Prot. Soc'y, 2005 ML 2117 (Mont., 13th Judicial Circuit, Docket No. DV-03-1281 May 24, 2005)

Tenth Circuit (and States) (Colorado, Kansas, Oklahoma, New Mexico, Utah, and Wyoming)

  1. Keith v. Rizzuto, 212 F.3d 1190 (10th Cir. 2000)
  2. Ramey v. Reinertson, 268 F.3d 955 (10th Cir. 2001)
  3. Reames v. Oklahoma ex rel. Okla. Health Care Auth., 411 F.3d 1164 (10th Cir. 2005)
  4. Hobbs v. Zenderman, 579 F.3d 1171 (10th Cir. 2009)
  5. Miller v. State Dep't of Soc. & Rehab. Servs., 275 Kan. 349 (2003)

Eleventh Circuit (and States) (Alabama, Florida and Georgia)

  1. Admin. Comm. For the Wal-Mart Stores, Inc. v. Horton, 513 F.3d 1223 (11th Cir. 2008)
  2. Alabama Medicaid Agency v. Primo, 579 So. 2d 1355 (Ala. Appeals 1991)

Federal Circuit (and States)

  1. In re Beal, 2005 D.C. Super. LEXIS 3 (Docket No. TR No. 2-99, May 11, 2005)

Diagram of a Special Needs Trust
Section 2346 from Georgia Medicaid Manual: Special Needs Trusts
HMS Trust Review Unit
Program Operations Manual System
What Trial Lawyers Need to Know About Special Needs Trusts

Legal Notices:
This document is intended as a legal research tool for attorneys. It is not intended for use by non-attorneys and is not a substitute for appropriate legal counsel. You may not rely on it as a substitute for legal counsel.

The law changes frequently and portions of this work may quickly become dated or obsolete. Further, as this document makes clear, the interplay between various legal concepts, such as trust law, public benefits law, tax law and property law is quite complex. Individual circumstances must be examined and this document makes no attempt to apply the law to specific facts.

CIRCULAR 230 NOTICE: To comply with the requirements imposed by the United States Treasury Department, any information regarding any U. S. federal tax matters contained in any communication from our office is not intended or written to be used, and cannot be used, as advice for the purpose of (1) avoiding penalties under the Internal Revenue Code or (2) promoting, marketing or recommending to another party any transaction or matter addressed in any communication from our office. Even if we discuss tax issues and our belief concerning the likely tax outcome from a particular strategy, tax opinions are expressly excluded from the scope of our representation and you cannot rely on our opinions as tax advice. If you would like a tax opinion, then you should consult with a tax professional.

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David L. McGuffey
Copyright 2004-2014 Elder Law Practice of David L. McGuffey, LLC
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