Ask Jaleh: What Is A Miller Trust?


Video Summary



What is a Miller Trust, and why would I need a Miller Trust in order to qualify for Medicaid?


Let's talk about first what is the purpose of a Miller Trust, also known as a Qualifying Income Trust.


A Miller Trust solves a single problem. The problem is that the person applying for Medicaid has too much income. A Qualifying Income Trust is an irrevocable trust into which you put your income, and which pays anything left over at your death to the state of Florida, up to the amount of the Medicaid benefits paid on your behalf.


If a Medicaid applicant's income exceeds the lawful amount for Medicaid eligibility, which is $2,199 per month – effective as of January 1, 2015 – a Qualifying Income Trust must be created with the applicant's income in order to create eligibility for long-term nursing home care. This insurance is also commonly referred to as a Miller Trust. This is an irrevocable trust.


The income of a 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 $105 per month of the income, and may be entitled to divert some of the income to the community spouse if the spouse's income falls below $1,966.25 per month. This is effective as of July1, 2015. They must also pay a fixed amount towards the patient responsibility for nursing home care.


In the event that there are excess funds in the amount after the applicant dies, Florida Medicaid is entitled to reimbursement from those funds.


Income from Medicaid eligibility purposes is considered gross income. This means that all deductions are added back into the income before one can determine the total amount of income for Medicaid eligibility purposes and is another example of why proper Medicaid planning is so important for each involved individual, and why a Qualifying Income Trust may be necessary.


The Qualifying Income Trust may be created by the applicant if the applicant is competent to do so. The Qualifying Income Trust may also be created by the applicant's spouse, if there is one, and if the spouse is competent to do so. The Qualifying Income Trust may also be created 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.


The form for the power of attorney must include specific authorization for the agent or attorney-in-fact to sign the irrevocable Qualifying Income Trust for the incapacitated person's skilled nursing home Medicaid eligibility.


If none of the above conditions exist, a court proceeding would be necessary to secure the authority to create a Qualifying Income Trust. Following the detailed requirements for drafting Qualifying Income Trusts and for administering an irrevocable Qualifying Income Trust is important for maintaining Medicaid eligibility for an elderly person after it is first obtained. Your attorney should provide you with detailed and specific directions for the proper funding and administration of the irrevocable Qualifying Income Trust.


The Qualifying 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, it must be a non-interest bearing account.


Please call me at 727-847-2288 for information about the Miller Trust, and if the Miller Trust is a proper planning tool for you and/or your loved one to become eligible for Medicaid for long-term skilled nursing care.