What is a Miller Trust in Florida?

In Florida Medicaid eligibility is a complex and stressful process, especially when your income exceeds the program’s strict limits. In Florida residents can use a special type of trust called a Miller Trust, or Qualified Income Trust (QIT). In Florida these trusts can provide make your income look lower than it is and permit you to qualify for Florida benefits that you were not qualified for otherwise.

Many Elder law attorney in Florida recognize that long-term care costs can quickly consume the financial resources of their clients.  Often Florida Elder Law Attorneys use a Miller Trust to permit their clients to qualify for benefits they would not otherwise be eligible for.

As a Florida Elder law attorney, I have created this guide to help you understand what is Florida Miller Trust and how a Florida Miller trust works to help provide benefits for your family.

In Florida and many other states a Miller Trust, also known as a Qualified Income Trust (QIT), is a legal arrangement used to help individuals become eligible for Medicaid when their income exceeds the Florida State permissible limit. As of Jan 1 2025, the income limit for a single person needing care is $2901.  It is important to remember that the is the gross income not the amount deposited into the account. Once must often look at the annual award letters to determine the actual income. The Miller trust is a irrevocable trust, which means that it cannot be changed outside the limits of what is permissible in the document.  Miller Trusts are most commonly by Florida Residents who who need long-term care services or other benefits from the state that are dependent on income limitations.  Some of these are also dependent on asset limitations, but this documented is only going to deal with the income limitations of those who are primarily attempting to obtain Medicaid benefits.

A Florida Miller Trust acts as a tool to manage income that exceeds Medicaid’s eligibility limits. Here’s how it works:

1. Income is Deposited into the Trust: Any income that puts an individual over the Medicaid income limit must be deposited into the Miller Trust account. This may include pensions, Social Security payments, or other regular income sources.

2. Funds Are Used for Approved Expenses: The funds in the trust are then used to pay for specific expenses, such as medical bills, long-term care facility costs, or personal needs allowances as defined by Medicaid guidelines.

3. Eligibility is Achieved: By placing excess income into the trust, the individual effectively lowers their countable income, meeting Medicaid’s strict financial requirements and qualifying for benefits.

It’s important to note that the trust is managed by a designated trustee, who ensures that funds are handled according to Medicaid rules and that all transactions are properly documented.  Using the trust can be complicated and involve many calculations on a monthly basis if the amount of income changes, the limits change, or the personal needs allowance changes. Our trusts and instructions have been designed a way to make this simple and easy to accomplish, even for those without strong math skils and without the need to involve a accountant.

Unlike other Florida trusts, a Miller Trust is designed to address income eligibility for Medicaid. Below are some key differences:

• Purpose: While most trusts are used for asset management, estate planning, or wealth transfer, a Miller Trust has a singular purpose: to help individuals qualify for Medicaid by reducing their countable income.

• Irrevocability: Miller Trusts are irrevocable, meaning they cannot be modified or canceled once established. This ensures compliance with Medicaid regulations.

• Income Focus: Unlike other trusts that often involve transferring assets, a Miller Trust deals exclusively with managing income, not assets like property or savings.

• Medicaid Rules: The trust is subject to strict Medicaid regulations, including limitations on how funds can be used and how the remaining funds are handled after the beneficiary’s death.

In summary, a Miller Trust is a powerful financial tool for individuals who need Medicaid assistance but have income that exceeds the eligibility threshold. By directing excess income into the trust and using it for approved expenses, beneficiaries can access vital healthcare services without jeopardizing their financial stability.

A Miller Trust, or Qualified Income Trust (QIT), is primarily used to help individuals with income above Medicaid’s eligibility limits qualify for essential Medicaid benefits. Its purpose is to bridge the gap between an individual’s income and Medicaid’s strict requirements, ensuring they can access critical long-term care services, such as nursing home care or in-home healthcare, without being disqualified due to excess income.

The main goal of a Miller Trust is to help individuals who exceed Medicaid’s income limits meet the program’s financial criteria. Medicaid eligibility is based on both income and asset limits, and exceeding the income cap—even by a small amount—can result in disqualification. For individuals who rely on Medicaid to afford long-term care services, a Miller Trust provides a legal way to redirect their income, allowing them to qualify for these vital benefits.

Here’s how a Miller Trust helps manage income to meet Medicaid requirements:

1. Redirects Excess Income: Any income that exceeds Medicaid’s eligibility threshold is deposited directly into the Miller Trust. This may include Social Security payments, pensions, or other income sources.

2. Lowers Countable Income: By placing excess income into the trust, the individual’s countable income is reduced to within Medicaid’s allowable limits. Medicaid only considers income outside the trust when determining eligibility.

3. Pays for Approved Expenses: Funds in the trust are used to pay for specific Medicaid-approved expenses, such as:

   • Medical care or long-term care facility costs.
   • Personal needs allowances (as determined by Medicaid).
   • Spousal allowances, if applicable.
   • Trustee fees for managing the trust.

By redirecting income through the trust, individuals can avoid the financial burden of paying out of pocket for costly healthcare services. This ensures they receive the care they need while staying within Medicaid’s financial guidelines.

In essence, a Miller Trust is a practical solution for individuals whose income is too high to qualify for Medicaid but too low to afford long-term care independently. It provides a pathway to access Medicaid benefits while maintaining compliance with program rules.

Medicaid is a vital program for individuals who need assistance with long-term care, but its strict income limits can disqualify people with even modest income levels. A Miller Trust, or Qualified Income Trust (QIT), is a financial tool that helps individuals meet Medicaid’s income requirements by redirecting their excess income into a trust.

Here’s how it works:

1. Redirecting Excess Income: Any income over Medicaid’s allowable limit is deposited into the Miller Trust. This reduces the individual’s countable income, enabling them to meet Medicaid’s eligibility requirements.
2. Complying with Medicaid Rules: The funds in the trust can only be used for Medicaid-approved expenses, such as medical care, long-term care facility costs, and personal allowances.
3. Facilitating Benefits Access: By using a Miller Trust, individuals can qualify for Medicaid benefits without having to spend their excess income entirely out of pocket.

Without a Miller Trust, individuals who exceed Medicaid’s income threshold—even by a small amount—would be responsible for covering all their care costs, which could quickly deplete their financial resources.

Miller Trusts are essential in various situations where income exceeds Medicaid’s limits. Below are some examples:

1. Retirees with Fixed Incomes:

   • An elderly individual receiving Social Security benefits and a small pension exceeds Florida’s Medicaid income limit by $200 per month. Without a Miller Trust, they would be ineligible for Medicaid, despite needing long-term nursing home care.
   • By depositing the excess $200 into a Miller Trust, their countable income falls within the allowable limit, enabling them to qualify for Medicaid.

2. Individuals Needing Long-Term Care:

   • A person with a monthly income of $3,000 requires nursing home care, but Medicaid’s income limit is $2,742. The cost of the nursing home is $8,000 per month, far beyond what they can afford without assistance.
   • Using a Miller Trust, they can deposit the $258 that exceeds Medicaid’s income limit. Medicaid then covers the nursing home costs, significantly reducing their financial burden.

3. Spousal Income Situations:

   • A married individual applies for Medicaid, but their combined income with their spouse disqualifies them. By redirecting their income into a Miller Trust, they meet eligibility requirements without affecting their spouse’s financial stability.

4. Individuals with Unexpected Income Changes:

   • A Medicaid applicant receives an unexpected cost-of-living adjustment (COLA) to their Social Security benefits, pushing them just above the income threshold. Establishing a Miller Trust ensures their continued eligibility without losing access to critical care.

Miller Trusts are often necessary when individuals have limited financial flexibility and need long-term care services. By managing excess income effectively, these trusts allow individuals to qualify for Medicaid benefits and access the care they need without unnecessary financial strain.

A Miller Trust, or Qualified Income Trust (QIT), is a vital tool for Florida residents whose income exceeds the state’s Medicaid eligibility limits. While the basic concept of Miller Trusts is consistent across the U.S., Florida has specific rules and regulations that govern their creation and use. Understanding these rules is essential for individuals seeking Medicaid benefits in the state. 

1. Eligibility Thresholds:

   • Florida Medicaid has strict income limits that vary depending on the type of Medicaid program. As of 2025, the income limit for institutional Medicaid (e.g., nursing home care) is $2901 per month  (1/1/25) for an individual. Any income above this limit requires a Miller Trust for eligibility.

2. Trust Setup Requirements:

   • The Miller Trust must be irrevocable, meaning its terms cannot be revoked or in most cases not changed without a court order. Sometimes it is easier to create a new one than to change the older one.
   • It must be drafted in compliance with Florida Medicaid regulations, often requiring the assistance of an elder law attorney. If an individual drafts their own trust or an attorney is not involved, the level of scrutiny is increase during the revised process which may cost a month’s eligibility or delays.

3. Income Deposits:

   • The applicant’s income that exceeds the Medicaid limit must be deposited into the trust each month.
   • Failure to deposit the correct amount of income could result in disqualification from Medicaid benefits.

4. Allowable Expenses:

   • Funds in the trust can only be used for specific purposes, including:
     • Medicaid-approved medical expenses.
     • Long-term care facility costs.
     • Personal needs allowances (currently $160 per month in Florida (1/1/24)).
     • Spousal income allowances (if applicable).
   • Misuse of funds could jeopardize Medicaid eligibility.

5. Remainder Funds After Death:

   • Any funds remaining in the trust upon the beneficiary’s death must first be used to reimburse the state of Florida for Medicaid benefits paid on their behalf. Any remaining balance can then be distributed to other beneficiaries.

In Florida, a Miller Trust, also known as a Qualified Income Trust (QIT), is designed to help individuals meet Medicaid income requirements while ensuring that their funds are used responsibly for approved expenses. The state imposes strict guidelines on how the trust’s funds can be spent, and misuse of these funds can jeopardize Medicaid eligibility. Below is a list of allowable expenses under Florida law: 

• Funds from the Miller Trust can be used to pay for out-of-pocket medical expenses, including:
  • Co-pays and deductibles for doctor visits or prescriptions.
  • Medical equipment and supplies not covered by Medicaid.
  • Therapies (e.g., physical, occupational, or speech therapy) prescribed by a healthcare provider.
  • Health insurance premiums, including Medicare or supplemental insurance policies. 

• One of the primary purposes of a Miller Trust is to cover costs associated with long-term care. These may include:
  • Nursing home or assisted living facility costs that are not covered by Medicaid.
  • In-home care services, such as home health aides or personal care attendants, if they are part of the Medicaid care plan. 

• Florida Medicaid permits a portion of the trust funds to be allocated for the beneficiary’s personal needs. The personal needs allowance is currently $160 per month (as of 2025) and can be used for:
  • Clothing.
  • Toiletries.
  • Small personal expenses. 

• If the Medicaid applicant has a spouse who is not receiving Medicaid benefits, part of the funds in the trust can be used to support the spouse. This is known as the spousal impoverishment allowance, and the amount is determined by Florida Medicaid rules 

• Reasonable administrative fees associated with managing the Miller Trust are also allowable, including:
  • Trustee fees (if a professional trustee is managing the trust).
  • Bank fees for maintaining the trust account.
  • Legal or accounting fees related to the setup and ongoing management of the trust. 

• Any remaining income in the trust, after personal needs and other allowances, is typically directed toward the beneficiary’s Medicaid share of cost. This is the portion of their income required to be paid toward their care before Medicaid coverage applies.

• Funds in a Miller Trust cannot be used for non-approved expenses, such as:
  • Gifts to family members or others.
  • Luxury items or unrelated personal purchases.
  • Expenses that do not align with Medicaid’s guidelines.

Proper management of a Miller Trust is essential to maintaining Medicaid eligibility in Florida. By ensuring that all expenditures align with state-approved guidelines, beneficiaries can access necessary care and services without financial or legal complications. Working with a knowledgeable trustee or elder law attorney can help ensure compliance with these regulations.

A Miller Trust, also known as a Qualified Income Trust (QIT), is a critical tool for individuals seeking to qualify for Medicaid when their income exceeds the eligibility threshold. It works by redirecting excess income into a specially designed trust, ensuring compliance with Medicaid’s strict income requirements. Here’s a step-by-step explanation of how a Miller Trust operates:

• Redirecting Excess Income: Each month, any income that exceeds Medicaid’s allowable income limit (e.g., $2901 for Florida Medicaid in 2025) must be deposited into the Miller Trust account. This includes:
  • Social Security benefits.
  • Pension payments.
  • Other recurring income.
• Mandatory Compliance: Depositing the excess income into the trust is not optional. Failing to deposit the required amount could result in the loss of Medicaid benefits.
• Bank Account Setup: A separate trust account must be established with a bank that accepts Miller Trust accounts. This account is solely used for trust-related transactions.

• Approved Expenses Only: Funds in the Miller Trust can only be used for Medicaid-approved expenses, such as:
  • Medical costs (e.g., co-pays, health insurance premiums).
  • Long-term care facility fees.
  • Personal needs allowances ($160 per month in Florida as of 2025).
  • Spousal income allowances (if applicable).
  • Administrative fees related to managing the trust.
• Remaining Income Contribution: After allowable expenses are paid, any remaining income in the trust is typically allocated toward the beneficiary’s Medicaid share of cost, which offsets Medicaid’s contributions to their care.

• Maintaining Clear Records: The trustee (the individual or entity managing the trust) must maintain accurate records of all transactions, including:
  • Deposits into the trust account.
  • Payments made from the trust for approved expenses.
• Compliance with Medicaid Rules: Detailed documentation ensures the trust complies with Medicaid regulations and avoids potential issues during eligibility reviews.
• Annual Reporting: In some cases, the trustee may need to provide an annual report to Medicaid or other authorities verifying the proper use of trust funds.

• Irrevocable Structure: The trust is irrevocable, meaning its terms cannot be altered once it’s created. This ensures Medicaid compliance.
• Trustee Role: The trustee (often a family member, attorney, or professional fiduciary) is responsible for managing the trust account, ensuring deposits are made on time, and distributing funds according to Medicaid rules.
• Post-Death Distribution: Upon the death of the beneficiary, any remaining funds in the trust are used to reimburse the state for Medicaid expenses paid on the beneficiary’s behalf. Any leftover funds can then be distributed to secondary beneficiaries if allowed by the trust’s terms. 

By following these steps, a Miller Trust helps individuals qualify for Medicaid while ensuring their income is managed in compliance with program rules. Properly setting up and maintaining the trust is essential to avoid eligibility issues and to maximize the benefits of Medicaid coverage.

Another step in establishing a Miller Trust is opening a dedicated trust account with a bank. This account will hold the income deposited into the trust and ensure proper management of funds in compliance with Medicaid rules. However, finding a bank that accommodates Miller Trust accounts can be challenging, as not all financial institutions are familiar with or willing to manage these specialized accounts. Below, we’ll discuss banks that offer Miller Trust accounts, potential challenges, and tips for navigating banks that do not support them.

Many major banks and credit unions are familiar with Miller Trust accounts and can assist in opening them. Examples include:

1. National Banks:

   • Bank of America: Offers Miller Trust accounts at select branches, often requiring additional documentation.  This bank can be challenging to deal with in regards to restricted accounts.
   • Wells Fargo: Known to provide Miller Trust accounts, though availability may vary by location.
   • Chase Bank: Accommodates Miller Trusts, but policies can differ depending on the branch.

2. Regional Banks:

   • PNC Bank: Offers Miller Trust accounts in areas where Medicaid planning is common.
   • Truist (formerly BB&T and SunTrust): Frequently assists with trust accounts, including Miller Trusts, particularly in the Southeast.

3. Credit Unions:

   • Local credit unions in Florida often provide flexible options for Miller Trust accounts, especially if they specialize in elder care or community services.

Despite the availability of Miller Trust accounts, there are some common challenges:

1. Lack of Awareness:

   • Not all bank employees are familiar with Miller Trusts, leading to confusion or misinformation about the requirements.

2. Inconsistent Policies:

   • Even within the same bank, policies can differ from branch to branch. Some branches may refuse to open Miller Trust accounts simply because they lack experience in handling them.

3. Documentation Requirements:

   • Banks often require specific legal documents, such as the trust agreement and proof of Medicaid application, which can delay the account opening process if not prepared in advance.

4. Limited Options in Rural Areas:

   • Individuals in rural areas may have fewer banking options, making it harder to find a bank that supports Miller Trusts.

Some banks explicitly do not handle Miller Trust accounts due to their unique requirements and administrative burden. If you encounter this situation:

1. Ask for Recommendations:

   • Consult with your elder law attorney or Medicaid planner for a list of banks in your area that accommodate Miller Trust accounts.

2. Search for Specialized Institutions:

   • Some banks and credit unions specialize in elder care financial services and are more likely to offer Miller Trust accounts.

3. Use Larger, Well-Known Banks:

   • Larger institutions are often more familiar with Miller Trusts. If a local branch is unfamiliar, contact the bank’s corporate office or another branch for assistance.

4. Document Preparation:

   • Before visiting the bank, ensure you have all necessary documentation, including:
     • The trust agreement (drafted by your attorney).
     • Medicaid application or approval documentation.
     • Identification for both the trust grantor and trustee.

5. Consider Alternative Trustees: 

• If finding a bank is particularly difficult, some individuals opt to appoint a professional trustee or financial institution that specializes in trust management, which can simplify the process.
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6. Banks That Do not Open Accounts for Miller Trusts: While many banks accommodate Miller Trust accounts, some financial institutions explicitly choose not to open or manage these specialized accounts due to their administrative complexity or lack of familiarity with Medicaid-related trusts. Below is a list of banks that are commonly reported to avoid opening Miller Trust accounts, along with tips on how to navigate this challenge.
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2. Capital One:

   • Known for its consumer-focused banking services, Capital One does not generally handle specialized trust accounts, including Miller Trusts.

3. Ally Bank:

   • As an online-only bank, Ally does not support Miller Trust accounts due to the unique documentation and administrative requirements associated with these accounts.

4. Discover Bank:

   • Discover primarily focuses on savings accounts, credit cards, and loans and does not offer services related to trust account management.

5. Online-Only Banks (General):

   • Many online banks, including Chime and Varo, do not provide trust account services due to the lack of in-person assistance and the specialized nature of trust accounts.

6. Smaller Community Banks (Varies by Location):

   • Some small community banks or local credit unions may not have the experience or policies in place to handle Miller Trust accounts.

By selecting the right bank and preparing all required documentation, opening a Miller Trust account can be a smooth process. It’s essential to research and consult with a Florida Elder Law Lawyer who understand the nuances of Medicaid planning to ensure compliance and avoid unnecessary delays.

A Miller Trust serves its purpose while the beneficiary is alive by helping them qualify for Medicaid and pay for essential medical and long-term care expenses. However, after the death of the beneficiary, specific processes must be followed to address the remaining funds in the trust and close the account. These steps are guided by Medicaid regulations and the terms of the trust.

• Medicaid Estate Recovery:

  • Any funds left in the Miller Trust at the time of the beneficiary’s death are first used to reimburse the state for Medicaid benefits provided during their lifetime. This process is part of Medicaid’s estate recovery program.
  • The state of Florida (or the applicable Medicaid agency in other states) is considered the primary beneficiary of the trust after the beneficiary’s death. The amount recovered cannot exceed the total amount Medicaid paid on behalf of the beneficiary.

• Priority of Reimbursement:

  • The trustee is responsible for determining the total amount owed to the state and paying this amount from the remaining trust funds before any other distributions can be made.

• Paying Final Expenses:

  • If any funds remain after reimbursing the state, they may be used to cover certain allowable final expenses, such as:
    • Unpaid medical bills.
    • Funeral and burial costs (if not prepaid).
  • These payments must comply with the terms of the trust and Medicaid rules.

• Distribution to Secondary Beneficiaries:

  • If funds are left over after the state and final expenses are paid, they can be distributed to secondary beneficiaries as specified in the trust agreement. This is rare, as Medicaid recovery often consumes most of the remaining funds.

• Account Closure:

  • Once all funds have been distributed, the trustee must close the Miller Trust account. This includes:
    • Finalizing all financial transactions.
    • Retaining records of deposits, expenditures, and distributions for compliance and legal purposes.
    • Providing a final accounting to the Medicaid agency or other relevant parties if required.

• Strict Compliance Required:

  • The trustee must ensure that all distributions and payments align with Medicaid and trust requirements. Mismanagement of funds can result in legal or financial consequences.

• Document Retention:

  • Trustees should retain detailed records of all transactions related to the trust, including Medicaid reimbursements, to address any potential audits or legal inquiries.

In summary, after the death of the beneficiary, a Miller Trust transitions from managing monthly income to settling financial obligations. The Florida Medicaid agency has the first claim on any remaining funds to recover the cost of benefits provided. By adhering to these guidelines, the trustee ensures the trust is closed properly and in compliance with all legal and Medicaid regulations.

When planning for Medicaid eligibility in Florida, you may encounter the terms Qualified Income Trust (QIT) and Miller Trust. These terms are often used interchangeably, which can lead to confusion, especially for those unfamiliar with Medicaid planning or trust terminology. Understanding the relationship between these terms and how they differ from other estate planning concepts is essential to navigate Medicaid requirements effectively.

Yes, in Florida (and most other states), a Qualified Income Trust (QIT) is simply another name for a Miller Trust. Both terms refer to the same legal tool used to help individuals with income above Medicaid’s limits qualify for benefits.

• Miller Trust: This term originates from a 1990 court case (Miller v. Ibarra) that established the legal precedent for using income trusts to meet Medicaid eligibility requirements.
• Qualified Income Trust (QIT): This term is more commonly used in legal and administrative settings, such as Medicaid applications and state regulations.

In practice, both terms refer to the same type of irrevocable trust that allows individuals to redirect excess income to qualify for Medicaid. In Florida, you might hear “Miller Trust” in informal discussions and “Qualified Income Trust” in official Medicaid guidelines, but they are functionally identical.

While the terms are interchangeable, understanding the nuances of Medicaid planning is critical to avoid confusion with other types of trusts or estate planning tools. Here are some common points of misunderstanding:

1. Miller Trusts vs. Asset Trusts:

   • A Miller Trust only addresses income that exceeds Medicaid’s eligibility threshold. It does not protect assets like savings, property, or investments.
   • Separate tools, such as irrevocable asset protection trusts, may be needed to address Medicaid’s asset limits.

2. Irrevocability:

   • Miller Trusts/QITs are irrevocable, meaning they cannot be changed or canceled once created. This distinguishes them from revocable trusts often used in estate planning.

3. Purpose-Specific Use:

   • The sole purpose of a Miller Trust is to manage income for Medicaid eligibility. It cannot be used for general estate planning or asset distribution after death.

4. Misunderstanding Medicaid Spend-Down:

   • Some individuals confuse Miller Trusts with Medicaid spend-down strategies, which involve reducing countable assets (not income) to qualify for Medicaid. While both strategies are aimed at meeting eligibility requirements, they address different financial aspects.

To minimize confusion, it’s essential to consult with an experienced elder law attorney or Medicaid planner who understands Florida’s unique rules and terminology. Here’s how to clarify and address potential misunderstandings:

• Clear Documentation:

  • When establishing a Miller Trust, ensure that the legal documents explicitly reference “Qualified Income Trust” to align with Medicaid regulations.

• Understanding Dual Needs:

  • For individuals whose income exceeds Medicaid’s limits but who also have significant assets, combining a Miller Trust with other Medicaid planning tools (e.g., irrevocable trusts or annuities) may be necessary.

• Avoid Misuse of Terms:

  • Be cautious about using “trust” generically in conversations about Medicaid planning, as it can lead to assumptions about asset management or estate distribution that do not apply to Miller Trusts.

In conclusion, Miller Trusts and Qualified Income Trusts are two names for the same Medicaid planning tool in Florida. Recognizing the interchangeable use of these terms and distinguishing them from other types of trusts is essential for successfully navigating Medicaid eligibility and long-term care planning.

Understanding how a Miller Trust works is essential for navigating Medicaid eligibility, but the process can raise many questions. Below are answers to some of the most common questions people have about Miller Trusts.

• Answer: While it is technically possible to draft and set up a Miller Trust on your own, it is highly recommended to work with an elder law attorney or Medicaid planner. Miller Trusts must meet specific legal requirements to comply with Medicaid regulations, and even minor errors can result in disqualification from benefits. An attorney can ensure the trust is properly drafted, funded, and managed, avoiding costly mistakes.

• Answer: If your income increases, you must deposit the additional income into the Miller Trust to remain Medicaid-compliant. For example, if you receive a cost-of-living adjustment (COLA) to your Social Security benefits or a new source of income, the excess must be added to the trust each month. On the other hand, if your income decreases and falls below Medicaid’s income threshold, you may no longer need the Miller Trust. An attorney or Medicaid planner can help determine the best course of action in either scenario.

• Answer: A Miller Trust only addresses the income of the Medicaid applicant. It does not directly affect the income or assets of a spouse. However, if the applicant’s income is redirected into the trust, it may impact the spousal income allowance, which is the amount of income the non-applicant spouse can retain under Medicaid rules. In such cases, the trustee can allocate funds from the trust to the spouse as part of this allowance. Consulting an attorney can help clarify how the trust interacts with spousal income.

• Answer: Medicaid rules and income limits vary by state. If you move, you may need to update or re-establish your Miller Trust to comply with the new state’s regulations. Before relocating, consult with an elder law attorney in your new state to ensure uninterrupted Medicaid coverage.

• Answer: No, funds in a Miller Trust can only be used for Medicaid-approved expenses, such as:
  • Long-term care facility costs.
  • Health insurance premiums.
  • Personal needs allowances.
• Misusing funds for non-approved expenses, such as gifts or luxury items, can lead to Medicaid disqualification.

• Answer: Medicaid eligibility is contingent upon properly managing your income. Failing to deposit the required excess income into the Miller Trust each month can result in loss of Medicaid benefits. The trustee must ensure all income above the Medicaid threshold is deposited on time to maintain compliance.

• Answer: After the beneficiary’s death, any remaining funds in the trust are used to reimburse the state for Medicaid benefits provided during their lifetime. Any leftover funds, if any, can be distributed to secondary beneficiaries as outlined in the trust agreement.

• Answer: No, not all banks offer Miller Trust accounts. Some financial institutions, particularly online-only banks, do not handle these specialized accounts. It’s important to work with a bank that is familiar with Medicaid planning and trust management.

• Answer: No, a Miller Trust and a Medicaid spend-down serve different purposes. A Miller Trust addresses income that exceeds Medicaid’s eligibility limit, while a spend-down involves reducing assets (like savings) to meet Medicaid’s asset limits. Both strategies are often used together for comprehensive Medicaid planning.

• Answer: Yes, every Miller Trust must have a designated trustee. The trustee is responsible for managing the trust account, depositing income, and ensuring funds are distributed for Medicaid-approved expenses. Trustees can be family members, attorneys, or professional fiduciaries.

If you have additional questions about Miller Trusts, consulting an experienced elder law attorney or Medicaid planner can provide personalized guidance tailored to your specific situation. Proper planning ensures compliance with Medicaid rules and helps secure access to essential care and benefits.

A Miller Trust, or Qualified Income Trust (QIT), is an essential tool for individuals whose income exceeds Medicaid eligibility limits but who need access to vital long-term care and medical services. By redirecting excess income into the trust and adhering to Medicaid’s strict guidelines, beneficiaries can qualify for assistance while ensuring their funds are used appropriately for approved expenses.

• A Miller Trust is specifically designed to help individuals qualify for Medicaid by managing income that exceeds the program’s limits.
• Properly depositing income into the trust each month and using the funds only for Medicaid-approved expenses are crucial for maintaining eligibility.
• After the beneficiary’s death, remaining funds in the trust are used to reimburse the state for Medicaid services provided during their lifetime.
• Setting up and managing a Miller Trust requires compliance with state-specific regulations, and working with an experienced trustee is highly recommended.

Establishing a Miller Trust can be a complex process, but the benefits of Medicaid coverage for long-term care and medical expenses far outweigh the effort. To ensure your trust is set up correctly and complies with Florida’s Medicaid rules:

• Consult an Elder Law Attorney or Medicaid Planner: These professionals specialize in drafting Miller Trusts and can guide you through every step, from creating the trust agreement to managing ongoing compliance.
• Reach Out for Personalized Advice: A financial advisor or legal expert can help tailor the trust to your unique needs and provide clarity on how it fits into your overall Medicaid planning.

By taking the right steps now, you can protect your financial future while gaining access to the care and support you or your loved ones need. Don’t wait—contact a Jacksonville Elder Law Attorney today to start the process of setting up a Miller Trust.

To learn more about Miller Trusts and navigate the Medicaid planning process effectively, it’s essential to rely on reputable sources and expert guidance. Below is a list of trusted resources, including Florida-specific Medicaid guidelines, federal publications, and legal advice platforms, to help you make informed decisions.

• Florida Department of Children and Families (DCF):
  Medicaid Program Overview and Eligibility Requirements
  This official website provides comprehensive information on Medicaid eligibility, including income limits and rules for Miller Trusts in Florida.

• Florida Agency for Health Care Administration (AHCA):
  Medicaid Programs and Services
  The AHCA oversees Florida’s Medicaid program and offers details on long-term care services, income thresholds, and state recovery policies.

• Centers for Medicare & Medicaid Services (CMS):
  Medicaid Basics and Eligibility
  The CMS website explains Medicaid eligibility requirements, including income limits and the role of trusts in qualifying for benefits.

• IRS Publication 525: Taxable and Nontaxable Income
  IRS Publication 525
  This resource provides guidance on income-related tax issues, which may be relevant when setting up or managing a Miller Trust.

• National Academy of Elder Law Attorneys (NAELA):
  Find an Elder Law Attorney
  NAELA connects you with experienced elder law attorneys who specialize in Medicaid planning and Miller Trusts.

• Estate Planning Lawyer Blog:
  

  Florida Estate Planning Lawyer Blog

  This site has user-friendly articles and tools to help you understand Miller Trusts and other Medicaid planning strategies.

• AARP:
  Medicaid and Long-Term Care Planning
  AARP provides articles and advice for seniors navigating Medicaid and long-term care options.

• American Bar Association (ABA):
  Medicaid Trust Resources
  The ABA’s website includes legal resources for trusts, Medicaid, and estate planning.

• Florida Elder Helpline:
  Call 1-800-963-5337 for free assistance and referrals to elder law attorneys, Medicaid counselors, and financial advisors in Florida.

• Area Agencies on Aging (AAA):
  Find Your Local AAA
  These agencies provide personalized assistance with Medicaid applications and Miller Trust setup.

These resources provide reliable information and professional guidance to help you navigate the complexities of setting up and managing a Miller Trust. For personalized advice tailored to your unique circumstances, consult our Jacksonville Florida elder law attorney or a Medicaid professional by calling 904-990-8000 or completing our intake form..