---
type: Reference
title: The Three Types of Special Needs Trust (Missouri)
description: First-party, third-party, and pooled special needs trusts differ by whose money funds them and whether Medicaid payback applies at death.
resource: https://nemolegal.com/special-needs-trust-missouri/
tags: [special-needs-trust, first-party, third-party, pooled, medicaid-payback]
timestamp: 2026-06-18
jurisdiction: Missouri
author: Patrick Nolan
---

# The three types

| Type | Funded with | Medicaid payback at death | Notes |
|---|---|---|---|
| First-party | The disabled person's own money (for example, a settlement or inheritance) | Yes, the state is repaid first | Only for those under 65 who meet the SSA definition of disabled |
| Third-party | Money from a parent, grandparent, or others | No | Whoever created the trust directs any remainder |
| Pooled | Individual accounts pooled and managed by a nonprofit | Yes, payback rules apply | Practical for smaller balances or when there is no individual trustee |

# Decision rule

Whose money funds the trust decides the type. The beneficiary's own funds require a first-party trust with payback. Family funds use a third-party trust with no payback. A small balance or the lack of a capable trustee points to a pooled trust.

# Related

- [Overview](/okf/special-needs-trusts/overview.md)
- [Trustee Duties](/okf/special-needs-trusts/trustee-duties.md)