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Tampa Estate Planning Attorney > Blog > Estate Planning > What is a “Miller Trust?”

What is a “Miller Trust?”


Trust can come in a variety of forms and are often used to qualify for a Medicaid or Medicaid Donating Home plan in Florida. Eligible trust funds are the irrevocable professional trust funds required by Medicaid in certain circumstances. Qualified income relationships are also called QIT or Miller Trust.

How is Miller Trust created?

Generally, Medicaid applicants create a Miller Trust, appoint a trustee, and open a bank account on behalf of the fund. The applicant’s income is transferred directly to the newly created escrow account (in most states payment must be transferred directly to the escrow account). In most cases, the applicant’s full income is paid into the escrow account, so it is not necessary to deposit funds directly into the applicant’s Medicaid account.

Please note the following additional rules for depositing funds in the escrow account:

  • A guarantee account must be opened with a balance of $0 or the minimum amount required by a financial institution to open an account. Deposits that are not considered as income will be disqualified from the Miller Trust in the month of the improper deposit.
  • You cannot add other funds to this fund. They can only consist of income to go to Medicaid applicants.
  • The exempted (not calculated) income cannot be attributed to the trust. Examples of income exempted are income tax refunds, certain pension benefits, Orange agent benefits, and family benefits
  • Income and interest earned by the trust may be cumulative and not considered resources.

How Does Miller Trust Work?

After payment, income can only be used for treatment. Generally, all income is transferred to a care facility, which allows the beneficiary to cover the care costs. Medicaid covers the difference between paid income and total care costs. You can get a grant of $40 from Miller Trust for your personal needs.

What is a “Payback Provision” in a Miller Trust? 

In the event of the death of an applicant/recipient of Medicaid, the state has priority in refunding Medicaid payments made on behalf of the recipient. All expenses remaining in the Miller Trust program after the death of the Medicaid applicant are reimbursed by the state to cover these expenses.

In exceptional cases, when the asset remains even after the government pays, the asset is paid to the other beneficiaries specified in the trust document. Generally, all income paid to the trust is spent each month as part of the “costs” of the beneficiary, so nothing remains.

Eligibility of Establishing Miller Trust

Anyone who is eligible for Medicaid, regardless of age, can create this type of trust. In addition, Florida Medicaid regulations do not recognize that money flowing through QIT and QIT accounts belongs to residents of the nursing home. The trust is the owner of the money. As a result, the applicant is entitled to Medicaid to cover the cost of home care.

Contact an Experienced Florida Estate Planning Attorney Today 

If you feel you need help with a Miller Trust or other type of estate planning issue, contact Tampa estate planning attorney David Toback today to schedule a consultation.


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