Special Needs Trusts: Allowable Expenses
Special Needs Trusts (SNTs), also sometimes referred to as Supplemental Needs Trusts, are used to provide supplemental benefits to disabled or elderly persons receiving governmental benefits (such as Medicaid and SSI) while not disqualifying them for the benefits.
There is a distinction between "self-settled" or "first party" trusts, which are funded with the disabled persons own assets, and most often called special needs trusts, and "third party trusts", which are set up by another person and funded with that person's money. The latter are often referred to as supplemental needs trusts. The laws regarding SNTs are very complex, and such trusts should be drafted only by attorneys experienced in that area of the law.
The administration of SNTs is also complex. Only certain types of expenditures are allowed. The wrong type of payments from the trust can disqualify the beneficiary from receiving governmental benefits. I currently serve as trustee for several SNTs - given the many needs of a disabled beneficiary, it can be a demanding job.
For examples of what expenditures from an SNT are allowable, and those that aren't, click "Continue Reading."
Allowable Expenses from a Special Needs Trust
(also applies to Pooled or Supplemental Needs Trusts)
A Special Needs Trust (SNT) is set up to cover the expenses of goods and services that are supplemental to the beneficiary’s basic needs (food, shelter and clothing). Food, shelter and clothing expenses cannot be covered by the trust. The following is a list of examples of some common expenses that are allowable through a SNT. This list gives a good idea of how a SNT can be creatively utilized to help enhance the quality of a person’s life, and is by no means all-inclusive. Some examples of allowable expenses are:
· Medications (essential and non-essential) not covered by Medicaid
· Medical equipment not covered by Medicaid
· Medical, nursing and dental care, tests not covered by another source
· Independent evaluations
· Insurance premiums (health, dental, life, auto, and renter)
· Homeowner insurance premiums ONLY if the insurance is NOT a mortgage requirement
· Personal assistance
· Private counseling and/or case management
· Guardianship and advocacy services
· Any expenses related to owning and operating one car
· Computer hardware and software
· Private lessons and materials
· Testing for any purpose (vocational, medical, psychological, etc.)
· Job coaching
· School or camp tuition
· Entertainment/recreation tickets
· Travel expenses such as transportation or hotel (but not food)
· Travel expenses for a companion
· Equipment (electronic, entertainment, adaptive, special interest)
· Home appliances
· Furniture and household items
· Gardening and lawn care
· Cable television
· Telephone services (local and long distance)
· Internet access
· Curtains, towels, linens, decorative items
· Interior decorating
· Home renovations to improve accessibility (but not additions)
· Gifts for the beneficiary at holidays
· Veterinary services, pet care, supplies
· Office supplies
Expenses Not Allowable from a Special Needs Trust An SNT is set up to cover the expenses of goods and services that are supplemental to the beneficiary’s basic needs (food, shelter and clothing). This means that the trust cannot be used for food, shelter or clothing costs on a regular basis or the trust will count as a resource to the beneficiary, which can affect eligibility for government benefits like Supplemental Security Income and Medicaid. The trustee must use discretion in making distributions, keeping the beneficiary’s government benefits in mind when doing so. The following is a list of basic need expenses that are not allowable through a supplemental needs trust. · Cash given directly to the beneficiary for any purpose · Food or groceries · Restaurant meals (except if given as an occasional gift) · Clothing (except if given as an occasional gift) · Rent or mortgage payments · Property taxes · Homeowners or condo association dues · Homeowners insurance if the insurance is a mortgage requirement · Utilities such as electricity, gas and water · Utilities hookup or connection charges
(also applies to Pooled or Supplemental Needs Trusts)
(because the beneficiary can use it for basic need support)
Source: Life Plan Trust, Inc. (a Pooled Trust Provider)


I am the fudiciary and legal conservator for my developmentally disabled sister. I have a special needs trust for her. She recently inherited $80,000 with an unknown amount to come.
I would like to purchase a home for her with these funds. Is this allowable.
How can I have these funds earmarked for this purpose without impacting her social security and medicaid?
RESPONSE: I person receiving SSI and Medicaid is generally allowed to own a home. I recommend that you consult with an attorney in your state who specializes in special needs trusts to determine the best course of action.
Hello: I am the beneficiary of a 3rd Party Special Needs Trust created under PA State law, with my brother as Trustee. I am currently in "Payback" mode with SSI because my 2007 real estate taxes were paid out of my Trust.
I don't understand that if I am permitted to own my home, where is the money supposed to come from to pay the taxes which amount to nearly $2,000 yearly? If they are not paid, I will lose my home.
RESPONSE: Real estate taxes, like rent payments, are considered basic support and are not permissible payments from a SNT. I recommend that your brother consult with an attorney in your jurisdiction who specializes in special needs trusts and SSI.
My friend has a SNT and is on Medicaid collecting both SSI and SSD.
If he no longer needs Medicaid, can the SNT pay for rent or housing going forward?
RESPONSE: Not if he is collecting SSI, as such payments will disqualify him.
What is the NC law (statute, regulation, or otherwise) governing supplemental needs trusts created by third parties?
RESPONSE: The primary laws are the NC Uniform Trust Code, NCGS Chapter 36C, and for Medicaid and Special Assistance, NC Department of Health and Human Service Manuals, which are available online.
I have a CA SNT with a NC beneficiary. The bene wants to buy a wheelchair lift out of trust funds. I don't see that it will be a problem. Where can I find the list of allowable expenses in the NC Code?
RESPONSE: There is no specific list of allowable expenses in the NC statutes.
I am trustee for a cousin who lives about 45 minutes away from me. When I go to visit or because he has requested me to come and we go to lunch can I use money from his trust for this.
RESPONSE: It depends on the purpose of your visit and the terms of the trust. I recommend consulting an attorney for an opinion.
I'm the trustee of my brother's third party, California, Special Needs Trust. He's been conserved by our county for over 50 years. I discontinued sending my brother a monthly allowance when I found out it wasn't allowed by SSI but I recently received an email from his conservator asking me to send "the allowed amount of $50 per month for his personal needs". Am I really allowed to do this?
RESPONSE: Probably, but that is a matter of California law.
I have a brother who is not on SSI now, but who will probably be in the future due to schizophrenia. I would like to set up a trust for him now, in the event that he needs funds for treatment, but I do not want him to know that he has these funds available. Can this be done? And who pays tax on the interest from the trust?
RESPONSE: Perhaps - it depends on state law. Income is taxable to the trust, the beneficiary or the trust grantor, depending on how the trust is drafted and/or how much is distributed from the trust. I recommend that you consult with an experienced special needs attorney.
If the special needs trust has taxable return on it's investments, who pays the tax? The trust or the owners which are the 2 children of the recipient...Thanks, CB
RESPONSE: It depends on what kind of special needs trust and what, if any, distributions are made.
My uncle is the trustee and beneficiary for my father's SNT. However, my uncle is with holding a lot of the money/necessities needed for my father. We are now questioning his motive. My uncle is in NC (as well the SNT) and he dropped my father off here in CA a year ago.... has left me and my husband to take care of everything medically but will not support our requests for more specialized doctor care, handicap home requirements, gas/transportation for my father, as well as taking care of home maintenance. Most importantly... the handicap issues in the home as well as ignoring the specialized doctor needs i.e. dental work. If uncle is not taking care of these matters and put a stip in the SNT stating that it is irrevokable.... what are we left to do?!?!?!
RESPONSE: You should be able to petition the court on behalf of your father to have your uncle removed as trustee. You should contact a North Carolina trust lawyer about this.