Long Term Care (LTC): Medicaid Income Pension Trust – Establish

Medicaid Income Pension Trust

OAC 317:35-5-41.6(6)(B)

A Medicaid Income Pension Trust (MIPT) is established for the benefit of an individual when the individual is in need of nursing home, ADvantage, or DDS waivered services and has countable income above the categorically needy standard for long-term care but less than the maximum monthly countable income for a Medicaid Income Pension Trust as found on OKDHS Appendix C-1, Schedule VIII.B.1. If the applicant’s gross monthly income exceeds the maximum monthly countable income for a Medicaid Income Pension Trust he/she is ineligible for Medicaid benefits

The MIPT is composed only of pension, Social Security, or other income of the individual along with accumulated income in the trust. Resources cannot be included in the MIPT.

The applicant is income ineligible until the trust is established and the monthly amount, as calculated in the paragraph above, is deposited into the MIPT account.

The remaining monthly income must be kept in a separate account. The funds from this separate/personal account are to be used to pay the nursing home vendor payment, deemed income to the community spouse, or are available to the ADvantage client for his/her living expenses.

If the client must serve a penalty period for transfer of assets before being approved for long-term care, they must establish and fund the MIPT for one month to start the penalty period. The amount must remain in the MIPT to be dissolved at a later date.

The trust must be irrevocable and cannot be amended or dissolved without the written agreement of the OHCA.  Trust records shall be open at all reasonable times to inspection by an authorized representative of the OHCA or DHS.

The State (OHCA) will receive all amounts remaining in the trust up to an amount equal to the total SoonerCare benefits paid on behalf of the individual subsequent to the date of establishment of the trust. This money belongs to OHCA and cannot be used for any reason unless approved by HR&MS.

Client and/or their representative must be advised to report any changes in income or expenses as soon as possible.

After staffing with your supervisor, requests to spend funds in the MIPT are submitted to AFS.HRMS@okdhs.org and HRMS2@okdhs.org  for approval or denial. No one, including APS workers and/or guardians, is authorized to spend any money out of the MIPT without prior approval. These decisions are not made at the county level.

Review the Medicaid Income Pension Trust (08MA023E (M-11)) on the Forms page of the InfoNet.

The following letter can be copied and pasted onto DHS Letterhead and sent when the client has been certified.

January 1, 2014
Mr. John Doe
1234 N. Wayne
Oklahoma City, OK 73107

RE:  Phillip Doe


Phillip Doe has been approved for nursing care or Advantage Waiver benefits and is required to have a Medicaid Income Pension Trust.  Each month $________ will need to remain in the trust. This monthly amount must be left in the account to accumulate. Funds from this trust can only be used to purchase medically necessary items not covered by Medicaid and must be approved by Department of Human Services state office staff.

When Social Security or other income increases or decreases it must be reported to your worker as soon as possible so an adjustment can be made to the amount deposited to the trust each month.

The trustee is entitled to compensation not to exceed 3% of the amount added to the Trust that month. Trustee may pay him/herself $__________ each month; this is 3% of the $__________, which must stay in the trust each month.

If you have any questions, please contact your worker at (555) 555-5555.


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