Navigating the complexities of special needs trusts requires careful consideration of permissible expenses, and the question of covering biometric medication tracking tools is becoming increasingly relevant as technology advances. These tools, designed to ensure medication adherence, can significantly improve the health and well-being of beneficiaries, but their allowance within a trust depends on the specific trust language and applicable state laws. Generally, a special needs trust can cover expenses that enhance the beneficiary’s quality of life, health, and well-being, without disqualifying them from needs-based government benefits like Supplemental Security Income (SSI) and Medicaid. However, it’s not always straightforward.
What Expenses *Can* a Special Needs Trust Cover?
A well-drafted special needs trust aims to supplement, not supplant, public benefits. This means it can pay for items and services that public benefits don’t cover, or to enhance the quality of those services. Permissible expenses typically include things like therapeutic activities, recreational opportunities, specialized equipment, and certain healthcare costs not covered by insurance. Crucially, the trust must be carefully constructed to avoid being considered a resource for SSI or Medicaid eligibility purposes. In California, as with many states, assets held in a properly structured special needs trust are not counted towards the beneficiary’s resource limit for public benefit eligibility. This is vital because exceeding that limit can lead to benefit disqualification. Approximately 1 in 5 children in the US have some form of disability, and proactive estate planning is critical for ensuring their long-term care.
Are Biometric Medication Tracking Tools Considered “Medical” Expenses?
The key to determining whether a biometric medication tracking tool is permissible lies in whether it can be classified as a legitimate medical expense. These tools often go beyond simple reminders; they can monitor physiological responses, confirm medication ingestion, and provide data to caregivers and physicians. If the tool is prescribed by a doctor as a necessary part of the beneficiary’s treatment plan, and the trust documents allow for payment of medical expenses, it’s more likely to be approved. However, documentation is critical. A doctor’s letter specifically outlining the medical necessity of the device is paramount. According to the CDC, medication non-adherence costs the healthcare system between $100 billion and $300 billion annually, highlighting the potential benefit of these tools. Without clear medical justification, it could be viewed as a discretionary expense, which may not be permissible.
Potential Issues and How to Avoid Them
One potential issue is the perception that the tool is a “luxury” item, rather than a medical necessity. If the device offers features beyond what is medically required, or if a less expensive alternative would suffice, it may be denied. Another concern is whether the tool creates an ongoing financial obligation that could jeopardize benefit eligibility. For example, if the tool requires a monthly subscription fee, it could be viewed as unearned income. To avoid these issues, the trust should be drafted with flexibility, allowing the trustee to exercise discretion in determining what expenses are reasonable and necessary. It is also important to consult with an experienced estate planning attorney and a benefits specialist to ensure compliance with all applicable laws and regulations. Steven F. Bliss ESQ. at The Law Firm of Steven F. Bliss specializes in these complex issues and can provide tailored advice.
A Story of Proactive Planning
I recall working with a family, the Millers, whose son, David, had a complex seizure disorder. David’s medications were crucial, but he occasionally missed doses, leading to breakthrough seizures. The Millers were concerned about his long-term care and wanted to ensure he received the best possible support. We created a special needs trust that specifically allowed for the payment of medical devices and monitoring equipment. When a new biometric medication tracker became available, the Millers were able to use trust funds to purchase it, providing them with peace of mind knowing David was receiving his medications consistently. This proactive approach not only improved David’s health but also preserved his eligibility for essential government benefits.
A Story of What Can Happen When Things Go Wrong
Conversely, I once worked with a family, the Johnsons, who attempted to use trust funds to purchase a similar device without proper planning. Their trust language was vague, and they didn’t obtain a doctor’s letter confirming the medical necessity of the tracker. The regional center initially denied the request, arguing that the device was a discretionary expense and not a covered medical need. The Johnsons were forced to appeal the decision, incurring legal fees and experiencing significant stress. Ultimately, they were successful, but the process could have been avoided with proper planning and documentation. This highlights the importance of careful drafting and proactive communication with benefits administrators.
43920 Margarita Rd ste f, Temecula, CA 92592Navigating special needs trusts and eligibility requirements can be complex. It’s crucial to work with an attorney experienced in this field. Steven F. Bliss ESQ. and The Law Firm of Steven F. Bliss offer comprehensive estate planning services to families with special needs, ensuring their loved ones receive the care and support they deserve. You can reach us at (951) 223-7000.
Don’t leave the future of your loved one to chance. Let Steven F. Bliss ESQ. help you create a comprehensive estate plan that provides for their long-term care and well-being. Contact us today for a consultation. Secure their future, with a plan that truly cares.