Medicaid Qualified Income Trust
(Miller Trust)

If a Medicaid applicant’s income exceeds the lawful amount for Medicaid eligibility ($2,742.00 effective Jan. 1, 2023), a Qualified Income Trust may be created with the applicant’s income in order to create eligibility for long-term nursing home care benefits.  This instrument, sometimes also called a Miller Trust, is an irrevocable Trust.

Income eligibility criteria change annually.  For the latest income eligibility requirements, click here.

How Does a Qualified Income Trust (or Miller Trust) Work?

The income of the Medicaid applicant which exceeds the eligibility criteria is placed in the Trust, and someone other than the applicant is the trustee. The Trust income will be disposed of in accordance with the directive of the Florida Department of Children and Family Services, after the applicant has applied for Medicaid and been approved. Generally speaking, the applicant will be allowed to retain $160 per month of the income. The applicant may also be entitled to divert some of his/her income to the community (well) spouse if the spouse’s income falls below the spousal Minimum Monthly Maintenance Needs Allowance.  The Trust pays a fixed amount towards the Medicaid recipient’s responsibility for nursing home care. In the event that there are excess funds in the account after the applicant dies, Florida Medicaid is entitled to reimbursement from those funds.

The Qualified Income Trust may be created by the applicant, if the applicant is competent to do so;  by the applicant’s spouse, if there is one and if the spouse is competent to do so; or by the attorney-in-fact pursuant to the applicant’s Durable Power of Attorney, provided the Durable Power of Attorney authorizes the agent to do so. If none of the above conditions exist, a court proceeding would be necessary to secure the authority to create a Qualified Income Trust.

The Qualified Income Trust must be properly managed, and payments must be made each month to maintain eligibility.  There are very specific rules that must be followed for the Trust. For example, trust money must be in a non-interest bearing account.

Contact The Karp Law Firm for assistance and information about the Qualified Income Trust.
Our elder law attorneys are experienced in this complex area of the law.


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