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A Miller Trust: What Is It And Why You Might Need One

Image of Miller Trust Medicaid long term care benefits  on estate management asset protection law site

A Miller Trust could be crucial if you need Medicaid long-term care benefits, but your income exceeds your state’s published income cap which would render you ineligible.

Creating a Miller Trust can help you receive the benefits you need without having to compromise your income.

An Irrevocable Trust

A Miller Trust is a type of irrevocable trust – meaning it cannot be altered or canceled – that holds excess income so you can qualify for Medicaid long-term care benefits. It’s called by different names from state to state. For instance, west of the Mississippi a Miller Trust is referred to by many different names. In Arizona, it’s called an Income-Only Trust. In Oregon, it’s called an Income Cap Trust. In New Mexico, it’s called an Income Diversion Trust. But, here in Georgia, it is called a Miller Trust, and occasionally someone might refer to it as a Qualified Income Trust. Any income that exceeds Medicaid’s limit is put into the trust and therefore not be counted as income. This allows the applicant to become eligible for Medicaid long-term care benefits.

How Miller Trusts Work

Like with other trusts, you assign a trustee to your Miller Trust. This would be someone other than yourself, perhaps your adult child, a friend or other family member. As you would with any trustee, you want to designate someone you trust will make financial decisions in your best interest.

The state in which you receive Medicaid long-term care benefits must be named the beneficiary of the Trust. Each month, all or a portion of your income will be deposited into the trust, depending on your state’s requirements. Your trustee will disperse money thereafter in compliance with state law and the guidelines set forth by the trust.

How To Determine If You Need A Miller Trust

Whether you need a Miller Trust or not depends on two things: where you live and your unique financial circumstances. If your income falls below your state’s published income cap, you’ll automatically qualify for Medicaid long-term benefits. If it doesn’t, you’ll need to know whether you live in a ‘medically needy’ (sometimes called ‘spend down’) state or a ‘categorically needy’ (sometimes called ‘income cap’) state. If you live in a ‘medically needy’ state, you will be allowed to spend excess income on medical care and expenses until you become income eligible for Medicaid long-term care benefits. If you live in an ‘income cap’ state, you will need to create a Miller Trust.

How Can I Set Up A Miller Trust Account

Setting up a Miller Trust is not something you want to attempt on your own. It is in your best interest to consult with an estate planning or elder law attorney. They can tell you whether you live in an income cap state and help you create a customized Medicaid Miller Trust account. Georgia is an income cap state, so if your income exceeds the state’s limits, you will need a Miller Trust.

We have been using Miller Trusts as part of our clients’ estate plans which always comes as a relief and surprise when they think they will not qualify for Medicaid long-term care benefits. If you would like to discuss setting up a Miller Trust to qualify for Medicaid long-term care benefits, give my office a call at 404-370-0696 and let us help you receive the benefits you need without compromising your income.


Looking to find an experienced estate lawyer in the Georgia area who is skilled in asset protection and estate plan preparation? Shannon Pawley is an attorney in Georgia with expertise in estate planning and asset protection. Shannon can provide assistance with creating an estate plan to include making a will and how to establish a trust properly. If you have questions about asset protection or questions about making an estate plan, reach out to Shannon and she will be glad to help answer all the estate planning questions you might have!

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