What Can a Special Needs Trust Pay For?

A special needs trust is designed to provide a person with a disability the funds to enhance her quality of life while at the same time allowing her to remain eligible for needs-based public benefits.  Government programs like Medicaid and Supplemental Security Income (SSI) provide essentials, such as medical care, food, clothing and shelter. Special needs trusts are intended to supplement, not replace, this kind of basic support. Such trusts pay for anything the trust document provides for, including comforts and luxuries that meager public assistance funds don't cover, hence the term “special needs.”

But what are these special needs? A special needs trust has been likened to a "parent's pocket" -- that is, it pays for the kinds of things that a parent would just reach into his or her pocket to cover.

These trusts typically pay for things like education, recreation, counseling, and medical attention beyond the simple necessities of life.

Here are some other examples of expenses that a special needs trust might cover:

  • Medical and dental expenses not covered elsewhere

  • Special equipment like wheelchairs or specially-equipped vans

  • Therapy or rehabilitation services

  • Training and education

  • Help with starting a business

  • Electronic equipment and appliances

  • Travel, including the cost of a companion

  • Recreation and entertainment (summer camp, movies or social events, videos, sports equipment)

  • Insurance

  • Legal or guardianship expenses

  • Burial expenses

However, there are other things a special needs trust should avoid paying for.  Trustees should typically never give an SSI or Medicaid beneficiary cash or a cash equivalent, or pay for food or shelter -- at least without first consulting a special needs planner.  The trustee, in consultation with the planner, might want to use trust funds for food and shelter if the trustee decides doing so is in the trust beneficiary's best interest despite a possible loss or reduction in public assistance.

Once you have taken cash, housing and food off the table, however, a special needs trust can typically pay for most other things a beneficiary might need to supplement his lifestyle. But because these rules are very complicated, it is always best to sit down with your attorney to discuss what you intend to do with your trust before making any payments to anyone.