The Latest from Our Firm

January 10, 2022

What is a Miller Trust?

When a Medicaid application exceeds the income limits for Medicaid, a Miller trust can provide a solution to help them still qualify. These are typically drawn up by an experienced Florida Medicaid planning attorney so that you can set it up at your bank. The primary function of this trust is to hold the excess income over the Medicaid income cap so an individual can still qualify for this important benefits program to pay for their long-term care needs.

How Does Income Get Calculated for Medicaid Eligibility?

Your gross income is used when calculating your financial eligibility for Medicaid benefits. This often includes payments you receive from Social Security or your pension. It’s important to verify the gross amounts you receive each month since many pensions have deductions for your health insurance, and taxes are taken out. The same can be said of Social Security payments made to you each month. In addition, it’s customary for your Medicare Part B premiums to be deducted from your payments, as well.

Using accurate gross income totals is crucial when determining how much you might exceed Medicaid’s income tax. Even so much as $1.00 over can disqualify you for long-term care assistance unless you have a Miller trust in place to catch this extra money.

Who Can Set Up a Miller Trust?

Also known as a qualified income trust, Miller trusts often need an experienced Florida attorney to assist in ensuring it is drafted and set it up correctly. As you plan for your retirement, you’ve probably quickly discovered how your income could create problems when applying for Medicaid and other government benefits programs. This makes the assistance of a qualified elder lawyer, like those here at The Florida Medicaid Planning & Elder Law Firm, invaluable.

When determining who can set up your trust, state law provides a list of who can do so:

  • The applicant or their spouse
  • An appointed guardian
  • A court
  • The applicant’s attorney through the use of a Durable Powers of Attorney

What are Common Challenges of Miller Trusts?

One of the more common issues of setting up a Miller trust is making sure your Medicaid planning attorney has the authority to do so on your behalf. If your durable power of attorney was created after October 1, 2011, greater scrutiny is placed on exactly where the document was initialed. Improperly designed powers of attorney can lead to many headaches and make it impossible to create this trust.

How Will My Miller Trust be Administered?

Every month you use Medicaid for long-term care, your Miller trust must have the correct amount of funding placed in it. Because these trusts work on a dollar-for-dollar set-off, having the right amount of income deposited to it each month is vital to maintaining program eligibility.

For example, if you are single and in need of Medicaid for your nursing home care in January, this is how you would create your eligibility:

If your countable assets are under $2,000 and you have a gross income of $2,500 per month, you are over the current Medicaid income cap by $118. Therefore, to make yourself eligible for January, you would need to deposit a minimum of $119 that month into your Miller trust. Doing so lowers your monthly income under the program restrictions, thus qualifying you for that month’s coverage. You would repeat this process every month you need Medicaid assistance for your long-term care needs.

Keep in mind that it’s always a wise choice to place more than the minimum necessary into your trust.

How Much Funding Am I Required to Put in a Miller Trust?

Typically, there are two primary ways in which you would put your income into a Miller Trust, as well as how much:

  • Single applicants must use all of their income to pay their care facility as part of their patient responsibilities.
  • Someone who is married and still has a spouse at home will need to divert only a portion of their income to their Miller Trust. The amount will depend on the spouse’s income.

Essentially, the money you put into your Miller Trust will cover your the costs of your personal care and then ultimately go to the nursing home for a single person. For those who are married, income rules somewhat differ depending on their circumstances.

What Happens to the Assets in My Miller Trust at Death?

Because a Miller trust operates as a way to pay back Medicaid and the nursing home, the few remaining assets left behind at death will get paid to the state.

Is There Any Chance I Can Avoid Opening a Miller Trust?

Typically, no. If you require long-term care Medicaid assistance in Florida, and your income exceeds program limits, a Miller trust is required. It is possible to have a pooled trust to collect excess income, but it must occur every month to maintain Medicaid eligibility.

Are Miller Trusts Useful for Other Medicaid Program Benefits?

In Florida, these trusts are only helpful for qualifying your income for long-term care Medicaid benefits. If applying for programs like Supplemental Security Income (SSI), it will be of no use.

When planning for your retirement and long-term Medicaid planning, it’s crucial to have a comprehensive evaluation of your current income and assets. A skilled Florida elder law attorney can assist you with this step and help you implement strategies that ensure you will be eligible when the time comes to apply.

Can The Florida Medicaid Planning & Elder Law Firm Help Me Set Up a Miller Trust?

We absolutely can.  One of the most important methods of protecting your Medicaid eligibility and avoiding costly delays in care is to work with a knowledgeable Medicaid planning attorney.  The elder law attorneys at The Florida Medicaid Planning & Elder Law Firm, we have assisted Florida families in setting up Miller Trusts for many years. If you or a loved one needs long-term Medicaid in the near future, we can help you get finances prepared.

Call 954-999-9683 to schedule your strategy session today. If your loved one is a Florida resident and needs long-term Medicaid, we can help, regardless of where you or your loved one is located. We have completed thousands of successful Medicaid applications, and we would be glad to help you and your family in this likely difficult time.


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