The Middle-Income Medicaid Gap
❌ Without a Pooled Trust
- •Income: $2,200/month
- •Medicaid limit: $1,717/month
- •$483 "too much"
- •Result: DISQUALIFIED
- •No homecare assistance
- •Pay $4,000-$8,000/month for private care
✅ With a Pooled Trust
- Income: $2,200/month
- $483/month goes to trust
- Trust pays medical expenses
- Result: QUALIFIED!
- Free Medicaid homecare ($5,000/month value)
- Keep your savings intact
How Pooled Income Trusts Work (Simple Version)
Step 1: Calculate Your Excess Income
The difference between your monthly income and the Medicaid limit ($1,717/month).
Your Income: $2,400/month
Medicaid Limit: - $1,717/month
Excess Income: = $683/month
Step 2: Deposit Excess to Trust
Each month, your excess income is automatically deposited into your pooled trust sub-account.
Your $683 goes into a trust account managed by a non-profit organization. The money is still yours—it's just held in trust.
Step 3: Trust Pays Medical Expenses
The trust uses your deposited funds to pay for qualified medical expenses:
- Prescription medications
- Medical supplies
- Co-pays & deductibles
- Medical equipment
- Dental & vision care
- Hearing aids
Step 4: You Qualify for Medicaid!
With your excess income going to the trust, Medicaid now sees your countable income as $1,717/month.
✅ You now qualify for full Medicaid homecare benefits—up to $5,000-$8,000/month in free care!
Who Should Consider a Pooled Income Trust?
✅ Perfect Candidates
- Monthly income: $1,717 - $3,500
- Need help with 2+ daily activities
- Assets under $32,396 (home & car don't count!)
- Regular medical expenses
- Want to keep savings intact
- NYC resident
💰 Cost vs. Value
One-Time Enrollment Fee
$500 - $1,000
Monthly Administrative Fee
$50 - $100
Value of Care You Receive
$5,000 - $8,000
per month in free homecare!
Pay $75/month, Get $6,000/month in care
= 8,000% ROI
Real NYC Families Who Qualified
Roberto & Carmen (Bronx)
Combined income: $2,845/month
Used pooled trust to qualify for CDPAP. Carmen now earns $3,200/month caring for Roberto. Household income actually increased while getting free care.
✅ Success Story
Linda (Queens)
Income: $2,100/month (retired teacher)
Just $383 "too much" for Medicaid. Set up pooled trust, qualified immediately. Now receives 25 hours/week of care from her niece.
✅ "Living my best life at 71"
The Patels (Jackson Heights)
Combined income: $3,200/month
"Everyone told us we made way too much." Set up dual pooled trusts (one for each spouse). Both now receive care at home with their son as paid coordinator.
✅ Family Preserved
The Application Timeline
Weeks 1-2: Trust Setup
- • Contact pooled trust organization
- • Submit application & documents
- • Pay enrollment fee
- • Open your sub-account
Weeks 3-4: Medicaid Application
- • File Medicaid application
- • Medical assessment (CFEE visit)
- • Submit financial documentation
Weeks 5-6: Approval
- • Medicaid reviews eligibility
- • Approval decision
- • Care plan developed
Week 7+: Care Begins!
- • Choose CDPAP or traditional care
- • Select your caregiver (family member if CDPAP!)
- • Services start
Total Timeline: 6-8 weeks from first contact to receiving care
Common Questions
Will this affect my Social Security?
No. Social Security and Medicaid are separate programs. Your benefits continue unchanged.
What happens to money left in the trust?
While you're alive, it stays in your account and pays your medical expenses. After death, Medicaid may recoup costs, but your home is protected for homecare services.
Can I get out of the trust later?
Yes! Pooled trusts are not permanent. You can exit if your circumstances change (though you'd lose Medicaid eligibility if income remains too high).
Will my spouse's income be affected?
Special spousal protection rules apply. Your spouse can usually keep their entire income. We'll help navigate this during your consultation.
Is this legal? It sounds too good to be true.
100% legal. Pooled Income Trusts are specifically authorized by federal law (42 USC 1396p(d)(4)(C)) and New York State regulations. They've been helping families for over 20 years.