Understanding Miller Trusts for Medication Qualification

If a senior has a gross income of over $2,349 per month they will be required to set up a Miller Trust before they can be eligible.

To qualify for Medicaid, a senior’s income and assets must fall below the established Medicaid guidelines. Often a senior has too much income to qualify yet cannot afford the cost of their assisted living or nursing-home care. For example, the current federal income limit for Medicaid eligibility is $2,349 per month, but costs for care can range from $4,000 to $10,000 per month.

What is a senior to do in this case? Idaho allows seniors to establish a qualified income trust, called a Miller Trust, where the excess income, over the income limit can be placed. When a Miller Trust is established, a senior is able to qualify for Medicaid even if their income exceeded the income limit, as long as the excess income is deposited into a Miller Trust Account and used toward the cost of their care.

After a Miller Trust document is created and an account set up at a banking institution, the excess income must be deposited into the Miller Trust Account each month, and then spent by the Trustee toward the senior’s care costs and other limited needs. The Trustee of the account cannot be the Medicaid applicant, since they are giving up their rights to those funds and entrusting the Trustee to manage the funds. A Miller Trust is not a way to protect funds from Medicaid, but rather a way to hold income in a protected manner so it can be used to pay for the senior’s care and allow the senior to qualify for Medicaid.

In conclusion, if a senior applies for Medicaid and has a gross income of over $2,349 per month, they will be required to set up a Miller Trust before Health and Welfare will approve them. In these cases, we advise calling our office or consulting with an elder law attorney prior to filing a Medicaid application to ensure that approval for Medicaid is not delayed.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity.

 If you have a question about a Senior’s legal, financial or healthcare needs, please call us.

July 2020