A first party trust is established when an individual receives a lump-sum payment that was not previously directed to a Special Needs Trust (ex: settlement, Social Security back payment, inheritance, etc). This type of trust allows an individual to retain this asset without jeopardizing their Medicaid benefit. However, upon the passing of the Trust Participant, Medicaid will seek reimbursement for any services provided during the life of the Participant. Individuals can designate that any balance in the Trust, upon the passing of the Participant, be given to a beneficiary or charity and this is completed after Medicaid receives its reimbursement. Alternatively, an individual can opt to leave any remaining funds in the Trust for the benefit of others also participating in the Trust, and those funds are not subject to Medicaid reimbursement.
A third party trust is established when a family member or person other than the individual directs funds to the Trust, specifically by passing the individual. This can be funded with cash, an insurance policy, annuity or as part of that family member or person’s own estate plan. In these cases, the granting party can determine how any residual funds are handled – whether to a named beneficiary or charity – as Medicaid cannot file a claim against these funds. The balance could also be left in the Trust for the benefit of other Participants.