A Miller Trust — also called a Qualified Income Trust (QIT) — may be required when a person's income exceeds Florida's Medicaid income limit, even if they need nursing home or long-term care and otherwise qualify. It's a specific legal tool with strict rules, and getting it wrong can delay or disrupt eligibility.
When a Miller Trust May Be Needed
Florida Medicaid has an income cap for long-term care eligibility. If a person's monthly income — from Social Security, pension, or other sources — exceeds that cap, they do not automatically qualify for Medicaid nursing home benefits even if their assets are otherwise within limits.
A Miller Trust may be required when:
- A person needs nursing home or institutional long-term care
- Their monthly income exceeds the Medicaid income limit
- They otherwise meet Medicaid's asset and functional requirements
Without a properly established Miller Trust, that individual may be ineligible for Medicaid coverage despite genuinely needing it and having limited resources.
What It Does
A Miller Trust works by directing the person's income — typically all of it — into the trust each month. The trustee then uses those funds according to Medicaid rules: a personal needs allowance goes to the individual, certain amounts may be allocated to a spouse, and the remainder goes toward the cost of care. Medicaid then covers the difference between what the trust pays and the actual cost of care.
Key points to understand:
- The income must flow through the trust correctly every month — it is not a one-time setup
- The trust must be irrevocable and meet specific Medicaid requirements to be valid
- At the person's death, remaining funds in the trust go to the state as reimbursement for Medicaid benefits paid
Medicaid eligibility rules are strict and time-sensitive. A correct structure matters from the start.
Call to discuss whether a Miller Trust applies to your situation and how to set it up correctly.
Why Proper Administration Matters
A Miller Trust is not a document you set up once and forget. It requires ongoing monthly administration. If income isn't deposited into the trust correctly, or if disbursements aren't handled according to Medicaid's rules, eligibility can be disrupted — sometimes retroactively.
Because of this, working with an attorney who understands Florida Medicaid rules is important both when establishing the trust and when managing it over time. Arrieta Law can help evaluate whether a Miller Trust is needed, structure it correctly, and ensure it is administered in a way that protects eligibility.