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Questions and Answers on Qualified Income Trusts  (Millers Trust) 

Q: Will Medicaid pay for my loved one's nursing home?

A: Medicaid nursing home benefits come with maximum income requirements. For 2014 that maximum is set at 2,169 per month. 

Q: If my income is more than the maximum allowable, is there any way to have medicare pay for my nursing home?

A: Yes. an irrevocable qualified income trust may be established so you can qualify for Medicaid nursing home benefits to help pay for the cost of long term care in a qualifying nursing facility.

Q: What happens to the money paid into the QIT?

A: All of the applicant’s income, including any income deposited into the trust account, is counted in determining the applicant's share of cost, which is the portion of medical expenses that remain the applicant’s responsibility.

But before paying the Medicaid applicant's share of cost, the trust can pay the Medicaid applicant a small personal needs allowance and, if married, it can pay the Medicaid applicant's spouse (called the community spouse) a monthly allowance. The amount that can be paid to the community spouse is called the minimum monthly maintenance needs allowance" (MMMNA). 

An income trust can also pay for Medicare premiums and medical costs not covered by Medicare and Medicaid.

Qualified Income Trust (Miller Trust)

An irrevocable qualified income trust, sometimes referred to as a "Miller Trust" or "QIT," is an irrevocable trust that is provided for by the Florida rules for Medicaid eligibility, so that one can qualify for Medicaid benefits to pay for long term care in a skilled nursing home for someone, even if they have more income than is otherwise allowed for Medicaid eligibility for benefits to pay for long term care in a skilled care nursing home.

​A QIT will allow you, or your family member, to qualify for nursing home Medicaid benefits to pay for nursing home costs regardless of whether skilled care nursing home resident has income that exceeds the "Income Cap" established for Medicaid eligibility. Currently, for 2014, the Medicaid income cap in Florida is $2,169 per month.

If the person seeking Medicaid for skilled nursing home care is incapacitated and unable to legally sign the irrevocable qualified income trust, it is necessary that there be a proper durable power of attorney in place so the Miller Trust can be established.

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