Understanding Special Needs Trusts in Massachusetts

Planning for a loved one with a disability requires special care. The goal is to provide financial support without jeopardizing eligibility for important government benefits like Supplemental Security Income (SSI) and MassHealth (Medicaid). In Massachusetts, a Special Needs Trust (SNT) is one of the most effective tools for accomplishing this.

Purpose of a Special Needs Trust

A Special Needs Trust is designed to:

• Preserve eligibility for benefits – Many government programs have strict income and asset limits. If a person with disabilities receives money directly (such as an inheritance), they may lose their SSI or MassHealth coverage. By placing funds into an SNT, the money is not counted as the beneficiary’s personal asset.

• Provide for “extras” – The trust can be used to pay for goods and services that improve quality of life, beyond what public benefits cover.

• Protect family resources – Parents, grandparents, or other relatives can leave assets to the trust, knowing that the money will be used for the benefit of their loved one without disrupting benefits.

There are two main types in Massachusetts:

1. First-Party (Self-Settled) SNT – funded with the beneficiary’s own assets (e.g., a personal injury settlement). Federal law requires that any funds remaining at the beneficiary’s death must first be used to reimburse MassHealth.

2. Third-Party SNT – funded with someone else’s assets (e.g., a parent’s estate plan). At the beneficiary’s death, any remaining funds can pass to other family members or heirs without a MassHealth payback requirement.

What a Trustee Can and Cannot Do

The trustee is the person or institution responsible for managing the trust. Their job is to use the trust funds for the sole benefit of the person with special needs, while following both Massachusetts and federal rules.

A trustee CAN use trust funds to pay for things like:

• Medical and dental care not covered by insurance

• Therapy, counseling, or rehabilitation services

• Education, training, and tutoring

• Personal care attendants or caregivers

• Recreation and travel expenses (trips, hobbies, vacations)

• Electronics, furniture, or clothing

• Special equipment, like wheelchairs, modified vans, or assistive technology

A trustee CANNOT:

• Give cash directly to the beneficiary (this would count as income and reduce or eliminate SSI benefits).

• Pay for food or shelter directly in a way that substitutes for SSI (for example, paying rent, groceries, or utilities). Doing so may reduce the SSI payment or cause ineligibility.

• Mix trust funds with personal accounts. The trustee must keep separate, accurate records.

• Use trust funds for anyone other than the beneficiary.

Why a Special Needs Trust Is Beneficial

A properly drafted and managed SNT provides:

• Protection of Benefits – Keeps the beneficiary eligible for SSI, MassHealth, and other programs that provide critical health coverage and monthly support.

• Asset Protection – Shields inheritances, gifts, or settlements from being spent down immediately to qualify for assistance.

• Peace of Mind – Parents and relatives can plan ahead, knowing that their loved one will have financial resources available without losing essential benefits.

• Flexibility and Support – Funds can be used to greatly improve the beneficiary’s quality of life by providing opportunities, services, and comforts that government programs don’t cover.

Conclusion

A Special Needs Trust is an essential tool in Massachusetts estate planning for families with a loved one who has a disability. By using this type of trust, you can ensure that:

• Government benefits remain intact.

• Assets are managed responsibly.

• Your loved one’s quality of life is enhanced without financial disruption.