Are you a special needs trust trustee?  If so, you already know how complex the rules about spending for the disabled beneficiary can be.  This article attempts to cover some basis ground rules and more specific examples of what a special needs trust trustee can and cannot buy with funds held for the disabled beneficiary.  It is a very basis article which does not dive down into the weeds of this complicated subject, so be advised that it should not be relied upon as legal advice.

Additionally, a special needs trust trustee must familiarize themselves with Missouri Medicaid (known as MoHealthnet) procedures.  A good place to start is to visit their website:  https://mydss.mo.gov/healthcare

When I meet with a special needs trust trustee at my office about the rules that they are governed by, I like to first provide them with some very basis ground rules.


First, as with any trustee, what a trustee can and cannot do is governed within the four corners of the trust document.  It is therefore not optional to thoroughly read the special needs trust and probably to do so a few times.  Whatever steps the special needs trust trustee may or may not want to take can be either approved or disapproved by the trust document itself.

Second, before getting into the specifics of what expenditures a special needs trust trustee can and cannot make, the best practice is for the trustee to pay an expense directly to the vendor and not to the disabled beneficiary to make the payment.  Remember, the basis of a special needs trust being allowed to hold an inheritance for a disabled individual yet not count as an asset available to them is that they don’t have access to the funds.  Violating this basic rule could result in the disabled beneficiary losing benefits.

Finally, do not try to guess your way through the process.  Check the special needs trust and you almost will always see a specific provision allowing the trustee to consult with a lawyer, an accountant, financial person or other needed professional for advice on how to best carry out your trustee duties.  Winging it is not a good plan….at all.


A special needs trust trustee may expend funds for the following:


  • one automobile/van
  • accounting/legal services
  • acupuncture/yoga/gym membership
  • appliances (TV, DVD, washer, dryer, microwave, refrigerator)
  • bus pass / public transportation costs / uber rides
  • camera
  • clubs/dues (e.g. health clubs, service clubs, advocacy groups, museums, zoo)
  • computers/software/internet service
  • conferences
  • courses/classes (academic or recreational/hobby)
  • curtains/blinds/drapes
  • dental work not covered by Medicaid
  • doctor specialists not covered by Medicaid
  • dry cleaning/laundry services
  • elective surgery
  • fitness equipment
  • furniture
  • gasoline / oil changes / other vehicle maintenance costs
  • holiday decorations, parties, holiday cards
  • home alarm systems
  • home improvements / home maintenance / landscaping + lawn service
  • home purchase
  • house cleaning services
  • insurance (auto/home)
  • linens / towels
  • massage
  • musical instruments / music lessons
  • non-food grocery items (e.g. laundry detergent, fabric softener, deodorant, soap, personal hygiene products, paper towels, toilet paper, etc…)
  • over-the-counter medications (including vitamins or herbal supplements)
  • pets and pet supplies
  • private counseling if not covered by Medicaid
  • repair services
  • sporting goods / athletic equipment
  • stationary / stamps
  • storage units
  • taxicab / Uber / Lyft
  • telephone services (cell phone)
  • tickets to concerts or sporting events (for beneficiary and accompanying companion)
  • utility bills that are not listed in ISM (e.g. cable TV, direct TV, internet)
  • vacations / travel (except SNT cannot pay for food).

* The best practice is for the Trustee to pay the above directly to the vendor.


– A special needs trust trustee should almost never distribute cash directly to the beneficiary.

– Providing debit cards or gift cards are usually seen as cash equivalents and should be avoided.

– SNT trustees should not make gifts to others on behalf of the beneficiary (e.g. no wedding, quinceanera or bar mitzvah presents). Gifts will result in a disqualification/penalty period.

– Do not pay for anything that is already paid for by another source and don’t pay for anything that is not in the best interest of the disabled beneficiary.

  • Cash given directly to the beneficiary for any purpose
  • Food or groceries
  • Restaurant meals (except if given as an occasional gift)
  • Rent or mortgage payments
  • Property taxes
  • Homeowners or condo association dues
  • Homeowners insurance if the insurance is a mortgage requirement
  • Utilities such as electricity, gas, and water
  • Utilities hookup or connection charges


Anyone reading this should understand that the rules regarding special needs trust trustee spending are extremely complex and filled with gray areas.  Therefore, no one reading this should be relying purely on this article as a foolproof guide to understanding the subject.

More to the point, a special needs trust trustee, as a fiduciary for a disabled individual must take prudent steps to protect the assets of the trust estate.  This would include seeking expert advice from an elder law lawyer St. Peters who can review the specific circumstances of your situation to offer solid advice.