Qualified Income Trusts (Miller Trusts)

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Qualified Income Trusts (Miller Trusts) – Elder Law Attorney and Jacksonville Lawyer Explains Qualified Income Trust

The Coleman Law Firm can assist you in the preparation of qualified income trusts (Miller Trusts), often referred to as a QIT, either as a stand alone trust, or as part of an overall Medicaid spend down plan.  You can schedule an appointment with our office, meet with our experienced Jacksonville elder law attorney, and we will prepare your qualified income trusts (Miller trusts) within your time requirements.  Your QIT will allow you, or your family member, to qualify for Medicaid benefits to pay for skilled nursing home costs regardless of whether your income exceeds the “Income Cap” established for Medicaid eligibility.  Currently, the income cap in Florida for 2020 is $2,349 per month.

If you, or your family member, who is living in a skilled nursing facility, has income in excess of that amount, a QIT must be established so he or she can qualify for Medicaid nursing home benefits to help pay for the cost of long term care.  For the purpose of determining whether you qualify for Medicaid benefits for nursing home care, the State of Florida includes indemnity payments you receive from long term care insurance as “income.”  If your income plus long term care insurance indemnity payments exceed the income cap, then you need qualified income trusts (Miller trusts).

If you would like to learn more about qualified income trusts (Miller trusts), or have such a trust prepared for you or your family member, please call our Jacksonville Medicaid attorney to schedule an appointment at 904-448-1969 for Jacksonville (toll-free 866-510-9099), the Palm Coast office at (386) 585-7004, or email us at Info@TheColemanLawFirm.com.

Qualified Income Trusts (Miller Trusts) – FAQs

1. What is a Qualified Income Trust?

If your monthly income is over the limit ($2,349 for 2020) to qualify for Medicaid long-term care services (including nursing home care), Qualified Income Trusts (Miller Trusts) (QIT) allow you to become eligible for Medicaid benefits by placing your income into a bank account each month that you need Medicaid benefits. The QIT involves a written agreement, setting up a special bank account and making deposits of your income into the account.

2. Who needs a Qualified Income Trust?

You need a QIT if your income, before any deductions (such as taxes, Medicare, or health insurance premiums) is over the $2,349 (for 2020) monthly limit to qualify for the Institutional Care Program (ICP), Institutional Hospice, Program of All-Inclusive Care for the Elderly (PACE) or the Home and Community Based Services (HCBS) waivers.  A properly drafted qualified income trust should allow you to qualify for any of the benefit programs listed.

3. How do I set up a Qualified Income Trust agreement?

You may find it useful to obtain professional help to set up the QIT agreement, but it is not required. However, the drafting of a qualified income trust is considered the practice of law and only members of The Florida Bar can legally prepare a qualified income trust for you in Florida.  Qualified income trusts (Miller Trusts) agreements must meet specific requirements and be approved by Department of Children and Families legal offices. You must submit a copy of the QIT agreement to an eligibility specialist who will forward it to DCF’s legal offices for review. If you would like a Jacksonville elder law and Medicaid planning attorney to assist you with the preparation and implementation of a Qualified Income Trust, please call us at The Coleman Law Firm, PLLC at (904) 448-1969, or at Palm Coast at (386) 585-7004,  toll free at 1-866-510-9099, or email us at Info@TheColemanLawFirm.com.

4. What items must be included in the Qualified Income Trust agreement?

The Qualified Income Trusts (Miller Trusts) agreement must:

Be irrevocable (cannot be canceled by you).

Require that the State will receive all funds remaining in the trust at the time of your death (up to the amount of Medicaid benefits paid on your behalf).

Consist of your income only. (Do not include or add assets).

Be signed and dated by you, your spouse, or a person who has legal authority (as legal guardian or pursuant to a durable power of attorney) to act on your behalf or who is acting at your request or the request of your spouse.  If the authority is through a durable power of attorney, the durable power of attorney must specifically provide that your agent, or attorney in fact, has the authority to establish trusts on your behalf.  You should review your durable power of attorney to determine if it has the appropriate provisions.

5. How does the Qualified Income Trust account work?
After setting up the account, you must make deposits into the QIT account every month for as long as you need Medicaid. This means you may need to make deposits before a Medicaid application is approved if you need Medicaid coverage. You cannot make deposits for a past or future month. Any income you receive back from the trust to you will be counted as income to you. If you fail to make a deposit in any given month, or to deposit enough income you will be ineligible for Medicaid payment of long- term care services for the month. As long you deposit income into the QIT account in the month it is received, it will not be counted when we determine if you are eligible for Medicaid for that month.
6. How much income must I deposit into the Qualified Income Trust account?

You must deposit enough income into the QIT account each month so that your income outside the QIT account is within the limits established by Medicaid program standards (currently $2,349 per month for 2020).

7. It is better to deposit more income than take the chance of depositing too little to qualify for Medicaid?
You should not deposit more than the amount of income actually received by the Medicaid beneficiary.  All funds remaining in the qualified income trust at the time of the beneficiary’s death are subject to Medicaid recovery and must be paid over to the State of Florida up to an amount equal to the Medicaid benefits provided.


Call (866) 762-2237 or visit the following website for information about current Medicaid income standards:


8. What happens to the income I deposit in the Qualified Income Trust account?
The income you have in and out of the QIT is used to calculate your patient responsibility. If you do have a patient responsibility, you are responsible for paying that amount. If there is money left in the QIT upon your death, it is paid to the State, up to an amount equal to the total medical assistance paid on your behalf by the state.
9. How do I pay funds remaining in the QIT to the State?
The QIT trustee or other individual acting on your behalf should contact the long term care facility to see if any refund for the month of death is due back to the trust. The balance of the QIT at the date of death, plus any refund from the long term care facility is to be paid to the State.

Mail a check payable to the “Agency for Health Care Administration” to:

Xerox State Healthcare, LLC
PO Box 12188
Tallahassee, FL 32317-2188

A brief cover letter or note should state that the payment is for a QIT and include the recipients name, Social Security number, and/or Medicaid ID number. Enclose a copy of the QIT bank statement covering the date of death to confirm the check is for the balance. Also, include documentation of any refunds received from the long term care facility. Contact ACS at (877) 357-3268 for questions regarding payment of QIT funds to the State.

Legal Notice and Disclaimer. The materials within this website are for informational purposes only. This information does not constitute legal advice and should not be relied upon by any individual. Communication of this information is not intended to create, and receipt does not constitute, the establishment of an attorney-client relationship. Internet users and readers should not act upon this information without first seeking professional legal counsel for your particular circumstances. The information on this website is provided only as general information which may or may not reflect the most current legal information.

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Copyright 2019. All Rights Reserved. The Coleman Law Firm, PLLC

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