How are Supplemental Needs Trusts Defined?

What items and expenses can be distributed?

Distributions ‘Supplement’ but do not Replace Assistance.

Distributions from a Supplemental Needs Trust cannot be made on behalf of the Beneficiary if the effect of such distribution is to replace, or to disqualify a Beneficiary from receiving Government Assistance. The Trust asset is available only to the Beneficiary as only the Trustee chooses or directs. The money in the Trust cannot be used for any other family members. The Trustee must refuse any payment request from the Beneficiary for services for which any public agency has the obligation to provide.

Examples of Allowable Distributions: Appropriate Non-support payments on behalf of a beneficiary include but are not limited to, payments for any of the following purposes:

1) medical, dental, and diagnostic work and treatment for which there are  no available private or public funds;

2) medical procedures, even though they may not be medically necessary or life saving;

3) differentials in cost between housing and shelter for shared and private rooms in institutional settings;

4) supplemental nursing care, rehabilitative and/or occupational therapy services;

5) care appropriate for a beneficiary that assistance programs do not otherwise provide;

6) expenditures for travel, companionship, and other expenditures that will improve the quality of the Beneficiary’s physical, emotional, psychological, and or spiritual health.

See the Following List on the next page for a more detailed account of allowable and disallowable items.

List of Supplemental Needs Allowable & Disallowable Expenses Which May Be Provided to the Beneficiary Only and No Other Family Members

Appliances, Washer/Dryer, Refrigerator, Microwave, etc Automobile, Insurance, Gasoline and Repairs/Maintenance

Cable T.V.

Camps, Day or Overnight

Cell and Telephone Services

Charlie Cards

Chiropractic Therapy


College Tuition, Books, Room & Board

Computer & Software, Tablets, Smart Phones, etc.

Credit Cards


Dental Care

Elective or Cosmetic Surgery

Entertainment Expenses – Movies, Baseball, Football (Sports of All Kinds) Concerts, Plays, Museums, etc.


Facial Care and Hair Removal

Food & Groceries (including meals at restaurants; unless you are on SSI and, if so, it is not allowed; however, if you are on vacation, these are allowed, even if you are on SSI. Yup, SSI will let you eat but only on vacation.



Hair Care (Color, Implants, Extensions, etc.)

Hearing Aids

Hobbies & Activities of All Kinds

Home Care & Supplemental


Home Improvements

Home Owner’s Insurance (allowed unless you on SSI, then it is not allowed)

House Cleaning

Household Products

Insurance Payments

Internet Services


Lessons (Music, Art, any)

Life Insurance

Manicure/Pedicure Massage

Medical Care Which is Not Covered by Insurance

Medical Devices

Mortgage (allowed unless you on SSI, then it is not allowed)

Personal Care Items

Pets of Any Kind

Physical & Occupational Therapy

Psychotherapy Real Estate Taxes (allowed unless you on SSI, then it is not allowed) Rent (allowed unless you on SSI, then it is not allowed)

Renter’s Insurance (allowed unless you on SSI, then it is not allowed)

Student Loans

Taxes of all Kinds Taxi Cabs Televisions(Regardless of Size)



Travel Expenses

Utility Bills (allowed unless you are on SSI, then it is not allowed)

Vacations (Anywhere in the World)

Veterinarian Bills

Wheel Chairs & Mobility Assistance Devices

Always Disallowed

“Loans” from Friends and Relatives Cash Withdrawals

Checks Made Payable Directly to the Beneficiary

This is NOT an Exclusive list. Please call if you have any questions.


The trustee should always pay the vendor. The trustee should not permit the beneficiary to purchase items and request a reimbursement.

We will provide you with information on how to obtain a special debit card in the name of the Beneficiary.

If the beneficiary receives Supplemental Security Income (SSI), they can only receive a monthly cash allowance of $20.00 Further, If you are on MassHealth, the factors which determine if you are allowed cash withdrawals are your household income; and whether you are single, married or have children or other dependents.

The within information is a generalization; every person’s individual facts are different. You cannot rely upon the information contained in this document without retaining a qualified Supplemental Needs Trust attorney. Lastly, NO other deposits are to ever be made into the trust other then a second settlement check.

Thomas R. Mullen
Thomas R. Mullen has been an attorney since 1977 and has devoted his practice exclusively to elderlaw since 1988. He is nationally recognized as one of the foremost experts on Medicaid planning. His additional Practice areas include estate planning and trusts for disabled people, as well as assisting attorneys with Medicaid lien allocations and the Medicare Secondary Payer Act. In the Spring 2013 issue of the National Academy of Elder Law Attorneys (NAELA) Journal, Attorney Thomas R. Mullen of Quincy, Mass. was described by the Academy’s Massachusetts past president and law professor William J.Brisk as being “a prominent and innovative elderlaw attorney.”