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Miller Trusts / Qualified Income Trusts

Miller trust and Medicaid

Understanding Miller Trusts and Qualified Income Trusts Can Be Tricky, But Necessary…

Far too many people get caught late in life draining their savings and assets providing for long-term healthcare when they have not appropriately planned for this eventuality. Some people think that Medicare will pay, and others think that Medicaid will pay.

The fact is if you want Medicaid to pay, and they will, you must plan ahead. You have to apply for and be approved for Medicaid. Another point most people don’t realize until it’s too late is that many people exceed the income limits to qualify for Medicaid and they don’t know that there are legal ways to qualify and be approved.

This is just one area that is typically covered in Estate and Asset Protection planning.

It’s heartbreaking to me when I see people come to me after their assets have been drained and they literally have nothing left.

A Miller Trust, also known as a Medicaid Qualified Income Trust (QIT) is one of the most common strategies utilized when an applicant is over the qualifying income limit to be deemed eligible for Medicaid.

Here’s how a Miller Trust works in Georgia.

The Georgia Medicaid Income Limit for 2023 is $2,742.00. Please note that when determining if an applicant exceeds the income limit that the focus is on the gross income received – not the net income deposited into the bank account. When a Medicaid applicant’s gross income exceeds the monthly Medicaid income cap, which changes from year to year and is currently around $2,700.00 per month, it is necessary to establish a Miller Trust. At a minimum, each month the amount of gross income that exceeds the Medicaid Income Limit should be transferred to the Miller Trust. The expectation is that the funds in the Miller Trust will be transferred out the same month of receipt for the applicant’s personal pay liability under the Medicaid Program or for other medical services/expenses. There is no need for Miller Trust if the applicant’s income is below the limit.

The Miller Trust is a document that describes the rules of the trust and names a trustee. The Georgia Department of Community Health has a preferred format for the trust document. Once the trust document is signed by the Medicaid applicant, their agent under a power of attorney, or their conservator, then the trustee can take the document to a bank and open a checking account. Each month the Medicaid applicant will transfer their income from their personal checking account to the QIT checking account. Then the trustee will pay the approved medical expenses out of the trust. The Miller Trust checking account will not retain any money.

If you or a loved one falls into this category, call The Estate & Asset Protection Law Firm immediately at 404-370-0696 and let us establish the Miller Trust for you or your loved one. Medicaid will not be approved until the trust is set up.


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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