Let’s Talk About What a Special Needs Trust Can Actually Pay For 

Look, I’ve been around the block with special needs planning, and here’s the deal: when you’ve got a loved one with special needs, you need to think smart about their future. Government programs like SSI and Medicaid? Sure, they help, but let’s be honest—they barely cover the basics, and they come with enough red tape to wrap around Texas twice. 

That’s where a Special Needs Trust comes in. It’s not just some fancy legal document—it’s your secret weapon for taking care of your family member without the government yanking away their benefits. I see too many families get this wrong and end up in a world of hurt.

Medical Stuff the Government Won't Touch

Let me tell you, Medicaid has more holes than my fishing net. A Special Needs Trust can fill those gaps: 

Alternative treatments that actually work? Covered. I had a client whose son needed acupuncture for chronic pain—Medicaid wouldn’t pay a dime, but their trust covered every session. 

Dental work? Absolutely. Have you seen what Medicaid covers for dental? Practically nothing. With a trust, your loved one can get the dental care they deserve, not just emergency extractions when things get bad. 

Quality therapies make a huge difference. Physical therapy, speech therapy, occupational therapy—the government might cover the bare minimum, but a trust can pay for the premium stuff that actually moves the needle. 

Mental health support is non-negotiable. In my experience, quality counseling and behavioral therapy can be life-changing, and a trust can make sure your family member gets the best care available, not just what the state is willing to pay for. 

Medical equipment that doesn’t fall apart in six months costs money. Wheelchairs, hearing aids, communication devices—the good ones that last aren’t cheap, and a trust can cover them. 

Having Some Actual Fun in Life

Life isn’t just about surviving—it’s about living. Your loved one deserves some joy, and a Special Needs Trust can make that happen: 

Social memberships matter. I had a client whose daughter joined a photography club through her trust. Two years later, she’s selling her work at local galleries and has made real friends. 

Adaptive sports change lives. Swimming lessons, specialized coaching, adaptive equipment—these things cost money but build confidence like nothing else. 

Creative outlets are essential. Art classes, music lessons—I’ve seen non-verbal kids express themselves through painting or piano when nothing else worked. 

Vacations aren’t a luxury, they’re a necessity. Everyone needs a change of scenery, and a trust can cover trips, companion costs, and those expensive but essential accessibility accommodations. 

Entertainment is part of being human. Concert tickets, movies, theme parks—these experiences create memories and bring families together. 

Education Beyond What the Public Schools Offer

Education doesn’t stop at what the district provides. A good Special Needs Trust can cover: 

Private schools that get it. If your local school is failing your child, a trust can pay for a place that actually understands their needs. 

Job training that leads somewhere. Vocational programs that build real skills—not just busywork—can be fully funded through a trust. 

College is absolutely on the table. Your family member might need extra support or specialized programs, but a trust can make higher education possible. 

Tutors who understand special needs education make all the difference. I’ve seen kids make years of progress in months with the right one-on-one support. 

Technology tools level the playing field. Specialized software, tablets, communication devices—these aren’t luxuries, they’re necessities for learning. 

Making a House a Real Home

While a trust generally can’t pay rent directly (that would trigger benefit reductions), it can cover practically everything else: 

Home modifications that work. Ramps, grab bars, widened doorways—I’ve seen these changes transform a prison-like environment into a place of independence. 

Smart home technology is a game-changer. Voice-activated systems, automated lighting, security features—they create independence that wasn’t possible before. 

Utilities keep the lights on. Internet, electricity, water—these bills can be paid directly through the trust without affecting benefits. 

Quality furniture that actually supports special needs. Adjustable beds, supportive chairs, sensory-friendly items—these make daily life manageable and comfortable. 

Home maintenance keeps everything running. Repairs, lawn care, cleaning services—these expenses add up fast, but a trust can handle them. 

Getting Around Town (and Beyond)

Transportation is freedom, plain and simple: 

Modified vehicles aren’t cheap, but they’re worth every penny. I’ve seen lives transformed when someone gets an accessible van they can actually use independently. 

Public transit passes provide daily independence. Bus fares, train tickets, specialized transport services—a trust can cover all of these. 

Ride services fill the gaps. When public transit doesn’t cut it, Uber, Lyft, or specialized transport services can be the difference between isolation and participation. 

Driving lessons and adaptive driving equipment open up new worlds. For those who can drive with modifications, a trust can fund the whole process. 

Vehicle maintenance keeps everything moving. Insurance, repairs, gas—these ongoing costs add up, but they’re all appropriate trust expenses. 

Help Around the House

Daily support makes independence possible: 

Quality caregivers are worth their weight in gold. A trust can pay for home health aides and personal care assistants who actually care and show up consistently. 

Respite care prevents family burnout. Taking care of a special needs family member is exhausting, and paid breaks for primary caregivers are essential, not optional. 

Companion services combat isolation. Sometimes what’s needed most is simply having someone to talk to or go places with, and a trust can pay for that. 

Housekeeping support maintains dignity. Cleaning services, laundry assistance, meal prep—these services keep a home functioning and healthy. 

Why This Matters More Than You Think

Here’s the bottom line: without a Special Needs Trust, even well-intentioned financial help can destroy benefit eligibility. I’ve seen it happen too many times—a grandparent leaves money directly to a grandchild with special needs, and suddenly they lose their Medicaid and SSI. By the time the family comes to me, they’ve burned through savings paying for care that used to be covered. 

A properly structured trust prevents this disaster while enhancing quality of life. It’s not about luxury—it’s about dignity, independence, and making sure your loved one doesn’t just survive, but thrives. 

Don’t try this alone. The rules are complicated and change frequently. Get a lawyer who specializes in special needs planning—not your cousin’s friend who does general estate planning on the side. Our team in Cedar Park has a record of helping families get this right, and we can help yours too. Call us today, and let’s make sure your loved one is protected for life. 

Thomas Fortenberry

Thomas graduated from The University of Texas at Austin School of Law with Honors in 2005. Thomas has a background in electrical engineering, business management, and mathematics. Thomas is an active member of the Texas State Bar including the Real Estate, Probate, and Trust Law section. Thomas is also registered to practice before the United States Patent and Trademark Office.