Q. What is AGED?

A. AGED is a Not-For-Profit organization, serving the elderly and disabled. AGED uses Special Needs Trusts, Grants and donations to help seniors and the disabled afford the care they need.

AGED is able to take monies that you have as assets, along with the income you receive monthly, and put it in a Trust. By virtue of the Trust, the state Medicaid Agency (DCF in Florida) can no longer count that money as income or assets. Meaning you can qualify for Medicaid Benefits!

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Q. What is the AGED Special Needs Pooled Trust?

A. The AGED Special Needs Trust is a Qualified Medicaid Pooled Trust for disabled individuals. The Pooled Trust is similar to a savings account. Simply place any monies over the Medicaid limit into your trust, which then allows you to qualify for government benefits. The state Medicaid Agency (DC`F in Florida) cannot legally count the money in your trust as income or assets.

The following is an excerpt from the Federal Statute that allows all Medicaid Pooled Trusts to exist:

"The qualified Medicaid Pooled Trust for disabled individuals is a legal instrument which meets criteria in 42 United States Code 1396(p)(d)(4)(c) and which allows disabled individuals to place assets and/or income into a trust to qualify for Medicaid assistance."

Note: The trust is irrevocable; however you still have access to your money for your needs!

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Q. Who needs a Trust?

A. Elderly and Disabled individuals who:

• Are over income / asset and need to qualify for government benefits
• Don't want to "spend down" their monies in an effort to resolve the over asset issue
• Need more available income to stay in a community setting, or to delay / prevent the need for Nursing Home placement
• Are facing end of Medicaid Nursing Home coverage and are unable to privately pay for their Nursing Home costs
• Need to enroll in the Medically Needy program
• Are enrolled in the Medically Needy program and want their income to be used for personal care outside of medical needs

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Q. Why would you want to use this Trust?

A. A Trust with AGED will allow you and / or your loved one to become eligible for benefits needed to take care of the expenses associated with today's rising healthcare costs. Possible benefits are:

• Medicare Part B Reimbursement
• Prescription Medications
• Durable Medical Equipment (DME) and Medical Supplies
• Home Health Aid
• Medical Co-Pays

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Q. What can be paid out of the Trust?

A. The following is a list of what can be paid for out of the Trust. If you have questions about whether or not something can be paid for out of the Trust, please contact AGED at: 407.682.4111.

• Long Term Care Insurance
• Rehabilitation
• Out of Pocket medical and dental expenses not covered by government benefits
• Transportation to and from appointments or events (including purchasing a vehicle)
• Personal Care Attendant for needs or escort to appointments or events
• Maintenance of items used to support the Beneficiary (house, vehicle, etc.)
• Private Health Insurance
• Travel / Trips to see family
• Purchase of goods and services that add pleasure to life (furniture, television, entertainment, etc.)
• Essential dietary needs (vitamins, supplements, etc.)
• Food & Shelter (rent, mortgage, utilities, etc.*)
• Legal, Guardianship, and Care Management services

*Checks are sent directly to the vendor, not the Beneficiary, and must be for the Beneficiary's support and needs.

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Q. What are Medicaid Benefits and what can they do for you?

A. Medicaid is a program that provides medical coverage to low income individuals and families. The state and federal government share the costs of the Medicaid Program.

Definition from the Florida Medicaid website, which can be viewed in its entirety at: http://www.dcf.state.fl.us/ess/medicaid.shtml.

The Federal Government allows this trust specifically for the disabled to assist with their long-term health care needs.

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Q. Am I disabled?

A. Social Security has 5 steps that determine disability.

You DO NOT have to be determined disabled by Social Security to use the Trust.

Step 1: Is the claimant engaging in substantial gainful activity now? If yes, the claimant is not disabled. If no, proceed to Step 2.

Step 2: Does the claimant have a non-severe (incredibly minor) medical impairment? If yes, claimant is not disabled. If no, proceed to Step 3.

Step 3: Does the claimant have a medical condition so severe that it is found on the Listing Impairments for automatic payment of benefits without further inquiry? If yes, pay the benefits. If no, proceed to Step 4.

Step 4: Can the claimant return to any type of work that the claimant has done in the past 15 years? If yes, deny claim. If no, proceed to Step 5.

Step 5: Given the claimant's Residual Functional Capacity, and considering the claimant's age, education, prior work experience and transferable skills, is there any type of alternative work that the claimant can do on a full time basis? If yes, deny claim. If no, pay the benefits.

***To clarify the Social Security Administration's (SSA) standards and procedures for the adjudication of titles II and XVI of the Social Security Act (the Act) of Disability and Blindness claims for individuals 65 or older. In particular this ruling explains that:

In general, the same regulations and procedures for determining disability for adults who are under the age of 65 are used when determining whether an individual aged 65 or older is disabled. Adjudicators are required to consider any impairment(s) the individual has, including those that are often found in older individuals. If an individual aged 72 or older has a medically determinable impairment, that impairment will be considered "severe."

If the individual's impairment(s) prevents the performance of his or her past relevant work (PRW), or if the individual does not have PRW, the adjudicator must consider two special medical vocational profiles showing an inability to make an adjustment to work before referring to Appendix 2 to subpart P of 20 CFR part 404.

Generally adjudicators should use the rules for individuals aged 60-64 when determining whether an individual aged 65 or older can adjust to other work. Some individuals aged 65 or older may not understand or be able to comply with our requests to submit evidence or attend a consultative examination (CE). Therefore adjudicators must make special efforts in situations which it appears that an individual aged 65 or older may not be cooperating.

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