Helpful Information: Medicaid/SSI
Prepaid funeral arrangements offer an applicant for financial
assistance under SSI/Medicaid the opportunity to completely pay for the funeral of their
choice before assets are used up for medical care and before their assets are reduced to
SSI/Medicaid eligibility levels. Effective January 1, 1997 - New York State law
mandates that all contracts for prefunded funerals executed by applicants for or
recipients of Medicaid be IRREVOCABLE.
Introduction
Many New York residents prearrange
and prefund their funerals as part of regular estate planning. In fact, many consumer
advocates applaud the concept. Reasons for preplanning ones final expenses include
peace of mind, relieving the burden on loved ones, or for purposes of SSI/Medicaid spend
down. There are a number of advantages to preplanning and prefunding funeral expenses. The
primary advantage is that it allows individuals the opportunity to make personal and
specific selections for the funeral service that most closely meets their needs. For many,
it is comforting to know that money has been set aside for their final expenses, which
will in turn reduce the burden on family members at a difficult time. In addition, loved
ones are not left guessing which type of funeral service would have been preferred.
Another very important reason to establish a preneed burial trust is that SSI/Medicaid
recipients are allowed to set aside money to fully fund the service of their choice before
their funds are exhausted down to necessary eligibility levels.
Consumers in New York State benefit
from the strictest, most comprehensive funeral preneed laws in the country. In New York
State, 100% of the principal and interest must accrue to the benefit of the trust (less a
third party Trustee administrative fee), which must be deposited in an investment backed
by the government of the United States. For this purpose, many New York funeral directors
use NYSFDAs funeral preneed trust program, the PrePlanSM. PrePlanSM
is a commingled trust invested solely in FDIC insured certificates of deposit. Five
Trustees, who are members of the New York State Funeral Directors Association and are
carefully appointed by the NYSFDA Board of Directors, oversee the operations of the trust.
PrePlanSM currently services 40,000 consumer trust accounts for over 500
funeral firms.
The Funeral
Prearrangement Conference
Below is a description of what you
should expect from a prearrangement conference.
The law requires the funeral
director to provide the consumer with the following:
1. A General Price List with
the current prices for any merchandise, services and facilities offered by the funeral
home.
2. A Preneed Itemization
Statement that lists the items of merchandise, services and facilities that have been
chosen, and the price of each.
3. A Preneed Agreement that
outlines all the terms, as well as a consumers rights as the Purchaser. It must also
state how the principal and interest will be applied to the cost of the funeral services
and merchandise at the time they are provided.
Different types
of Preneed Agreements
New York State mandates that
prearrangements with New York funeral firms MUST be REVOCABLE, except for
SSI/Medicaid recipients. This means that all prearrangements (except when prepared for
Medicaid spend down) may be canceled at any time prior to death and the entire balance,
including all accrued interest, must be refunded within ten days of the request.
New York State also mandates that
preneed burial trusts for applicants or recipients of SSI/Medicaid MUST be IRREVOCABLE.
This means that the prearrangement MAY NOT be canceled prior to death. It may,
however, be transferred to a different funeral home at any time.
Aside from being revocable or
irrevocable, there are essentially two types of preneed agreements. Following is a
description of each:
(1) GUARANTEED
The funeral home may offer a
guaranteed preneed agreement whereby the price of the funeral services and merchandise is
guaranteed not to exceed the balance in your trust account at the time that the funeral is
provided. The Guarantee will most likely be null and void if withdrawals are made from the
trust account and generally will not apply to certain items such as cemetery costs, clergy
fees, death certificate fees, etc. Please note, however, that the funeral home may not
charge more than the actual cost for these third party items.
(2) NON-GUARANTEED
A non-guaranteed agreement indicates
that the funeral home will provide the funeral services and merchandise selected at the
cost of those items at the time of your funeral. If the total cost of the funeral exceeds
the amount in the trust account, the additional expense will be due. If the total cost is
less than the balance in the account, the excess funds will be refunded (except
irrevocable trusts). The cost of the items at the time of your funeral must correspond
with the funeral homes printed General Price List at that time.
How Preplanning
Works
- Purchaser selects the funeral home of
their choice.
- Purchaser meets with a funeral
director.
- Purchaser selects desired services
and merchandise while reviewing the funeral homes General Price List.
- Funeral director prepares a fully
itemized statement and preneed agreement.
- Both the funeral director and
Purchaser sign the documents.
- Purchaser submits a check for the
cost of the funeral made payable either to the funeral home or a funeral trust program. If
cash is remitted, the Purchaser should obtain a cash receipt at the time of the
transaction.
- Purchaser receives copies of all
signed documents and a General Price List for retention.
- Within ten days, the funeral director
forwards the funds to a funeral trust program (i.e., PrePlanSM) or deposits the
money directly into a government backed, interest bearing account within a New York
financial institution.
- Within 30 days, the Purchaser should
receive a deposit acknowledgment in the mail indicating where the money has been placed.
- Funds are paid directly to the
funeral director once the funeral services have been provided.
Taxation of
Preneed Funeral Trusts
The Internal Revenue Service has
determined that Purchasers of preneed funeral trusts are responsible for any income tax
(if the Purchaser is required to file) resulting from interest earned on the trust
account. The funds, although set aside as payment for funeral expenses, always remain the
property of the Purchaser. With the exception of irrevocable trusts, a Purchaser always
maintains the right to withdraw the funds at any time prior to the performance of the
funeral. Although withdrawals are not permitted from irrevocable trusts, the funds may be
transferred to a different funeral firm at any time.
A Purchaser should receive a tax
information statement each year by January 31st, (i.e., 1099 or K-1Grantor
Trust Statement) indicating the amount of interest earned on the account for the previous
year. In addition, at any time upon written request, a funeral firm must provide a
Purchaser with an accurate balance including principal and accrued interest.
Most funeral firms are extremely
knowledgeable concerning all aspects of prepaid funerals in general, spicifics on
SSI/Medicaid, and often have the added benefit of local Social Services Department
relationships which may make this part of the "spend down" process go more
smoothly.
Important
Information for Applicants of Public Benefit Programs
"It was the judgment of
Congress that persons should not have to choose between lifesaving welfare assistance and
giving up their plan for the disposition of their bodily remains." A 1982 amendment
to the Social Security Act implemented a program whereby SSI/Medicaid eligible persons can
set aside funds for their funeral and burial before their resources are exhausted by
medical bills or their income declines to such a level that they need the cash assistance
provided by the Supplemental Security Income (SSI) program. This program was implemented
through specific resource exclusions for prepaid funeral contracts.
SSI, MEDICAID AND
MEDICARE..... Which is Which?
There is often confusion about what
each of these programs provide, specifically Medicaid and Medicare. Below are brief
descriptions of each:
Medicare
Medicare is authorized under the
Social Security Act and is part of a national health insurance program for the aged and
certain disabled persons. Medicare is administered by the Health Care Financing
Administration under the US Department of Health and Human Services.
Medicaid
Medicaid is a joint state-federal
health insurance program for low-income individuals. It is administered by individual
states with federal oversight and regulation by the Health Care Financing Administration.
Currently, all resources placed in an irrevocable funeral fund are excluded when an
individual applies for Medicaid. Revocable contracts as an excludable resource are limited
to $1,500. Please note that the revocable $1,500 limit is reduced proportionally by any
irrevocable funeral funds or insurance policies. State Medicaid plans are currently linked
to federal SSI eligibility criteria, however, individual states make their own Medicaid
determinations using the federal SSI criteria.
Supplemental Security Income
(SSI):
SSI is a means-tested, federally
administered income assistance program that provides monthly cash payments to the needy,
aged, blind and disabled in accordance with uniform nationwide eligibility requirements.
SSI is administered by the Health Care Financing Administration under the US Department of
Health and Human Services. The limit on countable resources for SSI is $2000 per
individual and $3000 per couple. All irrevocable preneed funds are excluded and any
revocable preneed funds of up to $1,500* for funeral expenses and unlimited burial space
expenses (funeral merchandise) per individual are excluded, with limited exceptions, for
SSI eligibility purposes.
Prepaid Funeral
Resource Exclusion
How to Qualify
Any individual who is an applicant
or recipient of SSI/Medicaid, and in the "spend down" process, should meet with
a funeral director. During a prearrangement conference, the individuals should select
which funeral services and merchandise he or she desires as disclosed on a "General
Price List." The funeral director will then note these selections on an itemized
statement (commonly known as a "Preneed Itemization Statement") which will
reflect the current retail value of the merchandise and services selected. The next step
is funding the arrangements. Funeral prearrangements will qualify as a prepaid funeral
resource exclusion if the funds are placed in an irrevocable prepaid funeral
trust account.
Meaning of Irrevocability
A trust which is titled "irrevocable"
means that any refund, withdrawal or other disposition of the deposits on account plus
accrued interest, for any purpose, will and must legally be refused by the funeral
director and/or funeral trust or financial institution.
Payments to Purchasers
Purchasers who have entered into
irrevocable burial trusts may only use the funds for payment of funeral services and
merchandise upon the death of the intended funeral recipient. Any excess in the trust
account after payment of funeral expenses must be returned to the local county Social
Services Department in which the intended funeral recipient resided, to be earmarked for
indigent burials.
Requirements
All documentation generated by this
process must meet stringent federal and state requirements for resource qualification and
funeral service disclosures. Social Services personnel require evidence that the funeral
arrangements exist and that they are linked irrevocably to the funding vehicle.
Additionally, all of the documentation generated by the funeral home must meet Federal
Trade Commission standards for price and itemization disclosure, and all of the provisions
of Section 453 of the New York State General Business Law.
Consumer Protections
The 1996 amendment to the Social
Services law which allows the creation of irrevocable trusts for applicants/recipients of
SSI and/or Medicaid also sets high business and ethical standards for prepaid funeral
arrangements. The following consumer protections were built into the law with that
amendment.
Portability
The law allows the consumer to
change funeral homes at any time prior to death without effecting the irrevocability of
the arrangements themselves. If such a transfer is desired, a new irrevocable preneed
agreement with the newly selected funeral home must be generated. The transfer of
irrevocable preneed funds may, however, ONLY be made payable to another funeral
home, or another funeral trust program.
Additionally, the law permits the
beneficiarys family, at the time of need, to select different goods and services
from those originally prearranged. Please note, however, that the funds in the account may
only be used for payment of funeral services and merchandise. Any remaining funds in
the account after payment of funeral services and merchandise, must be remitted by the
funeral director to the County Social Services Department.
Mandatory Contract Disclosures
New York law mandates that every
irrevocable preneed agreement contain in a minimum of 12 point type, the following
consumer disclosure:
"New York Law requires this
agreement to be irrevocable for applicants for receipt of supplemental security benefits
under section two hundred nine of the Social Services Law or of medical assistance under
section three hundred sixty-six of the Social Services Law, and for the moneys put into a
trust under this agreement to be used only for funeral and burial expenses. If any money
is left over after your funeral and burial expenses have been paid, it will go to the
county. You may change your choice of funeral home at any time."
All literature promoting prearranged
funeral and burial services prepared after January 1, 1997 must contain language
disclosing the irrevocable nature of burial trusts established for an applicant or
recipient of supplemental security income benefits or medical assistance. Following are
some samples of the language that could be used:
"New York State law mandates
that all contracts for prefunded funerals executed by applicants for or recipients of
Medicaid be irrevocable."
"New York State law mandates
that funeral trust funds for Medicaid recipients pay for funeral and burial expenses only.
These contracts must be irrevocable."
Summary of
N.Y.S. Irrevocable Trusting Statute (NY Social Services Law, Section 209)
** All preneed funeral
agreements for applicants for or recipients of Medicaid must be irrevocable.
** No other type of preneed contract
may be irrevocable. All others remain completely revocable for the
purchaser, which means monies must be refunded upon demand.
** There will be one irrevocable
account with an unlimited dollar amount for SSI/Medicaid applicants or recipients.
** Irrevocable burial trust
Purchasers may not receive a refund prior to the death of the beneficiary, at which time
the money must either be spent on funeral expenses or be paid to the county Social
Services Department.
** All irrevocable accounts must
remain portable to any funeral home in any state, and upon the purchasers request,
the monies must be paid to a newly selected funeral home or funeral trust within ten
business days.
** All preneed agreements for
applicants for or recipients of SSI/Medicaid must contain a mandatory disclosure regarding
the nature of the irrevocability of the contract and the portability aspects.
** All literature printed after
January 1, 1997 which promotes prefunded funerals must contain language disclosing the
irrevocable nature of preneed agreements executed by applicants for or recipients of
SSI/Medicaid.
Commonly asked
questions regarding preneed arrangements for applicants or recipients of SSI/Medicaid.
Can a Medicaid applicant apply
life insurance towards an irrevocable funeral trust?
No. Life insurance cannot be used in
an irrevocable trust.
Which items are to be excluded
from the burial trust?
None. Funeral prearrangements may be
completely prefunded.
Which county Social Services
Department would receive the overage in an irrevocable trust?
The county in which the Medicaid
applicant or recipient resided (most likely the county in which they applied for
assistance).
Must I send the overage of
existing revocable contracts held by Medicaid recipients to the county Social Services
Department?
No. The overage to existing
revocable contracts of Medicaid recipients should be returned to the Purchaser.
Who may authorize a transfer of
funds to another funeral home before death occurs?
The Purchaser or their legal
representative must authorize a transfer of the irrevocable trust to another funeral home.
Can I create an irrevocable trust
if the person is not yet an SSI or Medicaid applicant?
No. Only SSI/Medicaid
applicants/recipients may set up irrevocable preneed trusts in New York State.
Can an applicant or recipient
change an existing revocable contract to an irrevocable trust?
Yes, but they must sign a new
irrevocable preneed agreement.
Does the law affect pre-existing
contracts of Medicaid recipients?
No. If a consumer had both a
pre-existing agreement and was receiving Medicaid benefits prior to January 1,
1997, their account may remain revocable, and must still be recertified on an annual basis
by County Social Services personnel.
Can additional funds be added to
an irrevocable trust?
Yes.
Can irrevocable preneed
agreements be modified at time of need?
Yes, but if a less expensive funeral
is purchased, the overage must be remitted to the county Social Services Department.
Can we still use the personal
needs account to fund the burial trust.
No. The funeral director should not
be involved in the use of the Personal Needs Account. A Purchaser of an irrevocable burial
trust may still maintain the maximum allowable Medicaid eligibility personal resource
level, in addition to the irrevocable trust. That level is currently $3,550 per individual
or $5,150 per couple.
Are there disclosures that must
be printed on a funeral firms advertising materials regarding prearrangements.
Yes. Any promotional material
printed must contain language disclosing the irrevocable nature of burial trusts
established for individuals receiving or applying for supplemental security income or
medical assistance.
SEE ALSO
Pre-Planning
a Funeral
PrePlan Information
Before Prepaying a Funeral: Know Your Rights
Tips on Pre-Planning a Funeral
SSI/Medicaid Information

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