What is a Medicaid spend down and who qualifies…

Qualify for Medicaid with a Medicaid Spend Down

purple cross Irrevocable final expense trusts


To qualify for Medicaid, individuals must meet certain eligibility requirements depending on the state they reside. One must have a need for care and have limited income and assets. A person trying to qualify for Medicaid who has excess assets or income may qualify for Medicaid by entering into a Medicaid spend down.


Purple Cross offers irrevocable trusts for final expenses that meet state requirements. These trusts are not limited to just the individuals applying for Medicaid, but also for their spouses, parents and adoptive parents, minor and adult children, adoptive and step-children, siblings (brothers and sisters, adoptive and step-siblings, spouses of any of the above. None of the family members listed above need to be dependent on or living with the client to be considered immediate family members.


The amount one can put in an irrevocable final expense trust in most states is $15,000.00 per person. Washington state does not set a dollar limit. They state the amount set aside be reasonable related to the anticipated death related expenses in order to be excluded as a resource.


Every spend down has a story…


Purple Cross helped us protect assets that would have been used up to pay for private care

This past month the elder law attorney our family contacted recommended we call Purple Cross to help us with a Medicaid spend down for our mother. Our dad passed away five years ago and left mom with her house and there assets. Shortly after Dad’s passing, mom needed special care while still living in her home. The special care costs were very expensive and forced us to sell her home. Now mom needs full time care at a nursing home. With the money mom received from selling her home, she is spending almost $8,000 a month for her care. Purple Cross showed us how we can set aside funds for mom’s final expenses and also set aside fund in an irrevocable trust for myself and my siblings, including our spouses. This has allowed us to set aside thousands of dollars that we would have otherwise lost. We would recommend that everyone talk to Purple Cross before all of their assets are used to pay for private nursing home care. —Dick and Janet, Spokane, WA


Purple Cross Irrrevocable Trust Comply with Medicaid rules and regulations

The care center where dad was living suggested we call Purple Cross about setting up an irrevocable final expense trust to pay for funeral expenses while dad still has money in his account Dad was getting closer to having to apply for Medicaid to pay for his care center living expenses. Purple Cross was very helpful in explaining all our options and we purchased an irrevocable trust that complies with Medicaid rules and regulations. Now, dad has funds set aside to pay for his final expenses and these funds do not count against dad as an asset when he applies for Medicaid — Tom, Mt. Vernon, WA


We are so thankful that our purple Cross trust is protected from Medicaid and SSI

We are thankful we called Purple Cross. A lady from the state of Washington suggested we call Purple Cross about setting up an irrevocable trust that could be used to pay for mom’s funeral or cremation when she passes. Purple Cross helped us to set up a trust that is protected from Medicaid and SSI when she applies for state assistance for her nursing home care. We are very pleased with the service we received and would recommend Purple Cross to everyone. — Jamie and Scott, Tacoma, WA


Wish we had known about Purple  cross sooner

We recently contacted Purple Cross. They were very helpful. They helped us set aside funds for dad’s final expenses. We were limited to the amount we could place into dad’s irrevocable trust because we did not know about Purple Cross until after we started applying for Medicaid for dad. Had we known earlier, we could have placed more of dad’s funds into this account and could have placed additional funds into an account fo all of dad’s children and spouses. Our family is thankful for the service Purple Cross provided. We just wish we had k down about Purple Cross sooner. — Lonny and Sue, Longbeach, WA

Tell me more about

Medicaid and SSI Exemptions…

WAC 182-512-0500

SSI-related medical

Burial funds, contracts and spaces excluded as resources.


1. For the purposes of this section, burial funds are funds set aside and clearly designated solely for burial and related expenses and kept separate from all other resources not intended for burial. These include:


a. Revocable burial contracts;

b. Revocable burial trusts;

c. Installment contracts for purchase of a burial space on which payments are still owing;

d. Other revocable burial arrangements. The designation is effective the first day of the month in which the person intended the funds to be set aside for burial.


2. The following burial funds are excluded as resources for the client and spouse up to fifteen hundred dollars each when set aside solely for the expenses of burial or cremation and expenses related to the burial or cremation, and the funds are either:


a. An installment contract for purchase of a burial space that is not yet paid in full; or

b. In a revocable burial contract, burial trust, cash accounts, or other financial instrument with a definite cash value.


3. Interest earned in burial funds and appreciation in the value of excluded burial arrangements in subsection (2)(a) and (b) above are excluded from resources and are not counted as income if left to accumulate and become part of the separate burial fund.


4. The fifteen hundred dollar exclusion for burial funds described in subsection (2) above is reduced by:

a. The face value of life insurance with CSV excluded in WAC; and

b. Amounts in an irrevocable burial trust, or other irrevocable arrangement available to meet burial expenses, or burial space purchase agreement installment contracts on which money is still owing. If these reductions bring the balance of the available exclusion to zero, no additional funds can be excluded as burial funds.


5. An irrevocable burial account, burial trust, or other irrevocable burial arrangement, set aside solely for burial and related expenses is not considered a resource. The amount set aside must be reasonably related to the anticipated death-related expenses in order to be excluded.


6. A client's burial funds are no longer excluded when they are mixed with other resources that are not related to burial.


7. When excluded burial funds are spent for other purposes, the spent amount is added to other countable resources and any amount exceeding the resource limit is considered available income on the first of the month it is used. The amount remaining in the burial fund remains excluded.


8. Burial space and accessories for the client and any member of the client’s immediate family described in subsection (9) of this section are excluded. Burial space and accessories include:


a. Conventional gravesites;

b. Crypts, niches, and mausoleums;

c. Urns, caskets and other repositories customarily used for the remains of deceased persons;

d. Necessary and reasonable improvements to the burial space including, but not limited to:


i. Vaults and burial containers;

ii. Headstones, markers and plaques;

iii. Arrangements for the opening and closing of the gravesite; and

iv. Contracts for care and maintenance of the gravesite.


e. A burial space purchase agreement that is currently paid for and owned by the client is also defined as a burial space. The entire value of the purchase agreement is excluded; as well as any interest accrued, which is left to accumulate as part of the value of the agreement. The value of this agreement does not reduce the amount of burial fund exclusion available to the client.


9. Immediate family, for the purposes of subsection (8) of this section includes the client's:


a. Spouse;

b. Parents and adoptive parents;

c. Minor and adult children, including adoptive and stepchildren;

d. Siblings (brothers and sisters), including adoptive and stepsiblings;

e. Spouses of any of the above.


None of the family members listed above, need to be dependent on or living with the client, to be considered immediate family members.


[WSR 11-24-018, recodified as § 182-512-0500, filed 11/29/11, effective 12/1/11. Statutory Authority: RCW 74.08.090. WSR 04-09-003,  388-475-0500, filed 4/7/04, effective 6/1/04.]