Qualified Income Trust
Also known as a Miller Trust: qualifying for Medicaid long-term care when your income is over the limit.
What is a Qualified Income Trust?
A Qualified Income Trust (QIT), also known as a Miller Trust, is a legal tool that allows individuals in “income-cap” states like Florida to qualify for Medicaid long-term care benefits, even if their monthly income exceeds the state’s eligibility limit.
If you have over $2,000 in savings, you need an attorney to protect those assets. We recommend two local elder law attorneys below.
How a QIT works
- The income cap: if your gross monthly income, including Social Security and pensions, is higher than the state Medicaid limit, you generally cannot qualify for benefits. In Florida that limit is $2,982 per month. A QIT allows you to bypass this.
- How it functions: you establish an irrevocable bank account managed by a third-party trustee (you cannot be your own trustee). Each month, the portion of your income that exceeds the Medicaid cap is deposited directly into this QIT account.
- Strict spending rules: money in the QIT can only be used for specific Medicaid-approved expenses, such as your share of nursing home costs, health insurance premiums (like Medicare Part B) and personal needs allowances.
- State recovery: because it is an irrevocable trust, upon your passing any remaining funds in the QIT must go to the state to reimburse the cost of the Medicaid benefits you received during your lifetime.
Getting started
Medicaid rules are state-specific. If you would like to learn more about setting up a QIT, tell us which state you are located in and your approximate monthly income, and we can direct you to local legal resources and state Medicaid guidelines.
Local attorneys we recommend
- Chris A. LikensSarasota elder law attorney, and a founder who has served on the Medicaid board.sarasotaelderlawattorney.com
- Jessica CloseClose Legal, serving the Englewood area.closelegal.com
The number one estate planning document
Elder law attorneys regularly meet families in the same painful position: a husband or wife with dementia declines suddenly and needs memory care, but their spouse has no legal authority to admit them or manage their affairs without their agreement and cooperation.
That would not be an issue with a Durable Power of Attorney naming someone to act for them in legal and financial decisions. Once a person no longer has the capacity to sign legal documents, the only option left is guardianship.
Why guardianship is the last resort
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- There can be significant legal fees
Advance directives, such as a Durable Power of Attorney and a Designation of Healthcare Surrogate, are the recommended alternative. They let a person keep the dignity of their constitutional rights, can be executed quickly, and cost considerably less than a guardianship.
They must be put in place while you still have capacity to sign legal documents. If you or a loved one has had a recent diagnosis of dementia or a dementia-related disease, it is essential to act right away. There are pros and cons, so meet with an elder law attorney to discuss them.
This page is general information, not legal advice.
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