5 ms·

Yup. I have a child with autism. The American system is cruel beyond imagination. To qualify them for social security and Medicaid I have to leave them impov

Yup. I have a child with autism. The American system is cruel beyond imagination. To qualify them for social security and Medicaid I have to leave them impoverished. They can't have more than $2k worth of assets in their name. Instead it's a complex lawyer game of trusts to give my child any sort of inheritance. Yet they are basically guaranteed to end up in a group home (Even though I own my own home) because a caretaker after I go is unlikely. Further, what the trust can pay for is things not covered by Medicare and SS. So housing and food are limited to what the government would pay for. And then there's the concern of how this all plays out if I get dementia or disability which requires substantial finances. There's a reason people with autism tend to end up homeless.

wing-_-nuts 3y ago
You should also look into an able account. Your son can have up to 100k in assets invested in what's basically a 529 for people with disabilities. It can go towards housing and food. Get them on snap as well. Every little bit helps.
- cogman10 3y ago
  They aren't very old, so whether or not an able account is a good idea will depend on if they can manage money as an adult. The issue with able accounts is they are under the sole control of the account holder with few checks in place. Further, crossing that 100k line really sucks. If they let the funds ride and they appreciate past that level, they can lose their qualifications for Medicare/SS. For now, there's no rush, but it's something I've considered.
  - zie 3y ago
    As you approach $100k in assets, you get into special needs trusts.
    - cogman10 3y ago
      Right, but what happens when I die and there's 90k in the account? In 2->5 years, you'll need to start rolling money into the SNT, yet the only person that can do that is my kid. What if they don't have the wherewithal to know they have to do that? Able works if my kid can make ok financial decisions. It's a bad idea if they can't.
      - zie 3y ago
        If they can't make OK financial decisions, it doesn't really matter does it? There are 2 choices: - Either you set it all up ahead of time and they have someone you trust to watch over them after you are gone. - They get shunted into the system and whatever happens, happens.
        cogman10 3y ago
        I didn't say I'm not preparing things. I'm saying an able account isn't a slam dunk. An able account, if mismanaged, can disqualify my kid from Medicare. That means costly and time consuming legal intervention to correct while my kid misses out on medical care they need. The third option is waiting on the able account (not the SNT). There's little harm in waiting.
        zie 3y ago
        Of course it's not a slam dunk, but it's literally the best and (besides the complicated SNT) only option. Obviously, if you go over the limit, they would be disqualified while the balance is over. Again, I think you are way over-thinking this: - If the kid is responsible enough to handle it, then there is no problem. - If the kid isn't responsible enough, then someone will be the responsible party. - If you don't know if the kid is responsible enough yet, then you assume they aren't for the time being. No problem arises regardless of the state of their financial responsibility. It's not rocket science. As for waiting or not, that's your call, but you want compounding to work in your favour. Our current plan is ABLE and start the SNT hassle up as we approach the limit(which hopefully will go up before we reach it).
  - wing-_-nuts 3y ago
    If they're unable to manage it themselves, they'd need to have it managed by someone with power of attorney. That can probably be the manager of the SNT if you have one of those as well. Actually the SNT trustee can probably transfer funds from the SNT to the able account as needed. I'm not a lawyer, so it'd probably be good to talk to one about this.
mjmahone17 3y ago
I feel like the biggest thing the US could do is remove means-testing from our disability aid programs. Means testing usually does not feel like an effective way to distribute services. I want millionaires to be using government aid to help their children: just like with free education, when everyone who needs help uses it, the richer parents will demand, and ensure we pay for, higher quality for all. Everyone who is currently able to can all just pay a bit more in taxes to cover everyone’s accessibility and aid needs. I don’t want it to be possible for a child’s needs not to be met just because the state thinks the child’s family has too much money. Aid services should be treated like sidewalks and fire departments: almost everyone is going to need them at some point, why would you want to make it difficult to access?
- cogman10 3y ago
  At very least, it'd be nice if the means tests were tied to inflation rather than being increased based on congressional whims. I'm certainly pro universal health care, it would GREATLY simplify mine and my son's life. Private insurance is simply garbage when it comes to services for people with disabilities. With that in place, a much simpler trust system would work for my kid. It wouldn't be this complex system of checks to make sure they stick in line with current legislation standards. I wouldn't have to spend a large chunk of my child's funds on lawyers and trust administrators just to ensure legal compliance. I could cover basically all my kids needs other than medical, that stuff is just too expensive for anyone to afford.
- zer8k 3y ago
  > I feel like the biggest thing the US could do is remove means-testing from our disability aid programs. The problem isn't the means testing the problem is it's applied with broad strokes like all well meaning but inevitably awful government work. First, everyone pays into disability. So everyone should be able to get their share when necessary. Second, means testing includes things like housing, retirement accounts (which will be penalized severely if accessed), assets, and other things than just raw cash available. Just having a half decent computer is enough to make you fail means testing. So people who are on disability are almost universally forced to be poor. Don't try to hide your assets either. Shifting money/assets/etc to a family memory will still disqualify you. In a practical sense we also need to prevent the exploitation of disability programs. For example, self-inflicted disability (morbid obesity for example) should be subject to a different test of means than birth defects. If you're only disabled because you eat too much and can't be bothered to exercise I question whether you're actually disabled. Every "class" of disability is not equal and so we shouldn't treat them exactly the same. But, like all things, because the government runs it disabilities must be treated this way and as a result everyone suffers.
heyoni 3y ago
I know medicaid exemptions or waivers aren't tied to parental income but are you saying they're tied to the individual's assets? That seems scary.
- cogman10 3y ago
  > Single Applicant for Nursing Home Care Idaho seniors must be financially and medically eligible for long-term care Medicaid. They must have limited income, limited assets, and a medical need for care. A single individual applying for Nursing Home Medicaid in 2023 in ID must meet the following criteria: 1) Have income under $2,762 / month 2) Have assets under $2,000 3) Require the level of care provided in a nursing home facility. https://www.medicaidplanningassistance.org/medicaid-eligibility-idaho/ https://www.medicaidplanningassistance.org/medicaid-eligibil...
mech7654 3y ago
If you don't know already, go look up ABLE accounts. If your child became disabled before the age of 26, they can create an ABLE account and keep much, much more money in their ABLE account than they would otherwise be allowed to keep. ABLE account funds can be used for living expenses that cover the majority of expenses for most people- housing, healthcare, transportation, etc.
- cogman10 3y ago
  I'm aware. My kid is severe and whether or not that is a good idea is something I'll have to wait on. They aren't far enough along to really make the call on setting one up.
k8fj30gs 3y ago
This seems like a lot of work that still leaves your child at the mercy of the American system. Have you considered acquiring a second passport for your child somewhere with better social policies? If you have the capital to setup a meaningful trust fund many CBI programs should be within reach.

wing-_-nuts 3y ago

You should also look into an able account. Your son can have up to 100k in assets invested in what's basically a 529 for people with disabilities. It can go towards housing and food. Get them on snap as well. Every little bit helps.

cogman10 3y ago
They aren't very old, so whether or not an able account is a good idea will depend on if they can manage money as an adult. The issue with able accounts is they are under the sole control of the account holder with few checks in place. Further, crossing that 100k line really sucks. If they let the funds ride and they appreciate past that level, they can lose their qualifications for Medicare/SS. For now, there's no rush, but it's something I've considered.
- zie 3y ago
  As you approach $100k in assets, you get into special needs trusts.
  - cogman10 3y ago
    Right, but what happens when I die and there's 90k in the account? In 2->5 years, you'll need to start rolling money into the SNT, yet the only person that can do that is my kid. What if they don't have the wherewithal to know they have to do that? Able works if my kid can make ok financial decisions. It's a bad idea if they can't.
    - zie 3y ago
      If they can't make OK financial decisions, it doesn't really matter does it? There are 2 choices: - Either you set it all up ahead of time and they have someone you trust to watch over them after you are gone. - They get shunted into the system and whatever happens, happens.
      - cogman10 3y ago
        I didn't say I'm not preparing things. I'm saying an able account isn't a slam dunk. An able account, if mismanaged, can disqualify my kid from Medicare. That means costly and time consuming legal intervention to correct while my kid misses out on medical care they need. The third option is waiting on the able account (not the SNT). There's little harm in waiting.
        zie 3y ago
        Of course it's not a slam dunk, but it's literally the best and (besides the complicated SNT) only option. Obviously, if you go over the limit, they would be disqualified while the balance is over. Again, I think you are way over-thinking this: - If the kid is responsible enough to handle it, then there is no problem. - If the kid isn't responsible enough, then someone will be the responsible party. - If you don't know if the kid is responsible enough yet, then you assume they aren't for the time being. No problem arises regardless of the state of their financial responsibility. It's not rocket science. As for waiting or not, that's your call, but you want compounding to work in your favour. Our current plan is ABLE and start the SNT hassle up as we approach the limit(which hopefully will go up before we reach it).
- wing-_-nuts 3y ago
  If they're unable to manage it themselves, they'd need to have it managed by someone with power of attorney. That can probably be the manager of the SNT if you have one of those as well. Actually the SNT trustee can probably transfer funds from the SNT to the able account as needed. I'm not a lawyer, so it'd probably be good to talk to one about this.

mjmahone17 3y ago

I feel like the biggest thing the US could do is remove means-testing from our disability aid programs. Means testing usually does not feel like an effective way to distribute services. I want millionaires to be using government aid to help their children: just like with free education, when everyone who needs help uses it, the richer parents will demand, and ensure we pay for, higher quality for all. Everyone who is currently able to can all just pay a bit more in taxes to cover everyone’s accessibility and aid needs. I don’t want it to be possible for a child’s needs not to be met just because the state thinks the child’s family has too much money. Aid services should be treated like sidewalks and fire departments: almost everyone is going to need them at some point, why would you want to make it difficult to access?

cogman10 3y ago
At very least, it'd be nice if the means tests were tied to inflation rather than being increased based on congressional whims. I'm certainly pro universal health care, it would GREATLY simplify mine and my son's life. Private insurance is simply garbage when it comes to services for people with disabilities. With that in place, a much simpler trust system would work for my kid. It wouldn't be this complex system of checks to make sure they stick in line with current legislation standards. I wouldn't have to spend a large chunk of my child's funds on lawyers and trust administrators just to ensure legal compliance. I could cover basically all my kids needs other than medical, that stuff is just too expensive for anyone to afford.
zer8k 3y ago
> I feel like the biggest thing the US could do is remove means-testing from our disability aid programs. The problem isn't the means testing the problem is it's applied with broad strokes like all well meaning but inevitably awful government work. First, everyone pays into disability. So everyone should be able to get their share when necessary. Second, means testing includes things like housing, retirement accounts (which will be penalized severely if accessed), assets, and other things than just raw cash available. Just having a half decent computer is enough to make you fail means testing. So people who are on disability are almost universally forced to be poor. Don't try to hide your assets either. Shifting money/assets/etc to a family memory will still disqualify you. In a practical sense we also need to prevent the exploitation of disability programs. For example, self-inflicted disability (morbid obesity for example) should be subject to a different test of means than birth defects. If you're only disabled because you eat too much and can't be bothered to exercise I question whether you're actually disabled. Every "class" of disability is not equal and so we shouldn't treat them exactly the same. But, like all things, because the government runs it disabilities must be treated this way and as a result everyone suffers.

heyoni 3y ago

I know medicaid exemptions or waivers aren't tied to parental income but are you saying they're tied to the individual's assets? That seems scary.

cogman10 3y ago
> Single Applicant for Nursing Home Care Idaho seniors must be financially and medically eligible for long-term care Medicaid. They must have limited income, limited assets, and a medical need for care. A single individual applying for Nursing Home Medicaid in 2023 in ID must meet the following criteria: 1) Have income under $2,762 / month 2) Have assets under $2,000 3) Require the level of care provided in a nursing home facility. https://www.medicaidplanningassistance.org/medicaid-eligibility-idaho/ https://www.medicaidplanningassistance.org/medicaid-eligibil...

mech7654 3y ago

If you don't know already, go look up ABLE accounts. If your child became disabled before the age of 26, they can create an ABLE account and keep much, much more money in their ABLE account than they would otherwise be allowed to keep. ABLE account funds can be used for living expenses that cover the majority of expenses for most people- housing, healthcare, transportation, etc.

cogman10 3y ago
I'm aware. My kid is severe and whether or not that is a good idea is something I'll have to wait on. They aren't far enough along to really make the call on setting one up.

k8fj30gs 3y ago

This seems like a lot of work that still leaves your child at the mercy of the American system. Have you considered acquiring a second passport for your child somewhere with better social policies? If you have the capital to setup a meaningful trust fund many CBI programs should be within reach.