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By Frederick Misilo, Jr.
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  • Additional physician visits (over the Medicaid limit)
  • Appliances
  • Bicycle, fitness equipment, personal trainer
  • Bottled water
  • Bus or train pass
  • Cab scrip
  • Cable TV bill
  • Car/Van: fuel, repairs, maintenance, insurance
  • Cell phone
  • Club dues
  • Computer, internet service, software, training, repairs
  • Curtains, blinds, drapes
  • Dental work, eyeglasses, hearing aids, batteries not covered
  • Dermatology not covered by Medicaid
  • Drugs unavailable through Medicaid (non-generic)
  • Entertainment, movie or theater tickets
  • Furniture
  • Haircuts manicures, pedicures, and other salon services
  • Health club membership
  • Hobby supplies
  • House cleaning/maid service
  • Incontinence supplies and equipment
  • Laundromat/Dry Cleaners
  • Legal fees/Guardian fees
  • Lessons, classes or college tuition and fees
  • Linen
  • Massage, Acupuncture/Acupressure, Rolfing and other alternative treatments
  • Musical instruments
  • Non-food grocery items, such as:
    • laundry soap, bleach, household cleaning products, tissues, paper towels, napkins, deodorant, soap, personal hygiene products
  • Orthopedic shoes/podiatry
  • Over the counter medications
  • Oversight, monitoring, and advocacy
  • Painting and music therapy
  • Payment of private health insurance premiums
  • Personal attendant services beyond Medicaid limits
  • Pets, pet supplies/food, pet care (veterinarian bills, etc.)
  • Private counseling
  • Record/Book clubs
  • Rehabilitation and physical therapy beyond Medicaid limits
  • Respite care
  • Telephone bill or phone card
  • TV, VCR, DVD player, stereo
  • Vacation
  • Vitamins, Herbs
  • Wheelchairs not covered by Medicaid; repairs, driving gloves

CAUTION: Do not distribute funds directly to the beneficiary. The above goods and services must be paid directly from the trust to the vendor or service provider. Distributions from a first-party special needs trust must be for the sole benefit of the beneficiary.

About the Author
Frederick M. Misilo is the Chair of the firm's Trust and Estate Department and is a member of the firm's Management Committee. His practice focuses on all aspects of estate planning, including the areas of elder law, special needs planning, estate administration, trusts and foundations, guardianship, and adult service advocacy.