Qualified Income Trusts

Qualified Income Trusts (sometimes called "Miller" trusts or a "QIT") may be used when a Medicaid applicant's gross income is higher than Medicaid's monthly income limit. If an applicant’s income exceeds the income cap they will be denied benefits unless a QIT is established and properly funded. Gross income is comprised of Social Security payments (including any Medicare Part B premium), pension income, certain VA benefits, interest/divided income, and other types of unearned income.

We are often contacted by individuals whose assets are below the Medicaid asset cap and have applied for benefits but have been denied because their income is too high. Medicaid treats assets and income separately, and if an applicant's income is too high a QIT will be required even if they meet the asset limit. Establishing a QIT in these circumstances is of utmost importance because Medicaid benefits will not begin until the month in which the QIT has been established and properly funded.

One critical question when establishing a QIT is who will establish the trust if the Medicaid applicant is unable to act on their own behalf. In these circumstances, only the applicant’s spouse or a properly-designated agent under a durable power of attorney can establish a QIT for the applicant. Further, the applicant’s durable power of attorney must specifically authorize the agent to establish the QIT. If the applicant does not have a power of attorney and there is no spouse that can establish the trust, then a guardianship proceeding will be necessary (guardianship proceedings are expensive, burdensome on all involved, and it is much better to simply make sure the applicant has executed a durable power of attorney along with a complete set of updated advance directives).

We charge a flat fee for our qualified income trust services, based upon a fixed fee schedule. These services include 1) confirming Medicaid eligibility, 2) preparation and execution of the QIT, 3) assistance with establishing the trust, 4) follow-up consultations to ensure the trust is administered properly by the trustee, and 5) assistance with handling trust assets upon the death of the Medicaid recipient.

If you or a loved one is in need of a qualified income trust we encourage you to schedule a consultation by calling our office at 954-227-7320 or using our online contact form (we will follow up with you within one business day).