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For many individuals in Pennsylvania who rely on essential Home and Community-Based Services (HCBS) waiver programs, having a monthly income that is slightly above the program limit can threaten their eligibility. The Income Spend Down (ISD) Trust offers a vital solution, allowing individuals to deposit their excess income to qualify for the HCBS waiver and continue receiving essential healthcare and support services at home.

What is an Income Spend Down Trust?

The HCBS waiver program requires applicants to meet specific financial eligibility criteria, including a maximum gross monthly income of $2,982, among other requirements, in order to receive waiver services. The Income Spend Down Trust Program offered by Achieva Family Trust is designed for waiver applicants whose monthly income exceeds this limit by up to a few hundred dollars. This allows an applicant’s “excess income” to be deposited into an “Income Spend Down” pooled trust, allowing the individual to maintain eligibility for waiver services. Individuals age 65 and older who utilize an Income Spend Down Trust are additionally required to spend down these trust funds each month on qualified medical or care-related expenses.

Click here to read more about Income Spend Down Trusts. 

June 2026 Trust Matters Newsletter