Qualified Income Trust FAQs
Jacksonville elder law attorney answers Qualified Income Trust FAQs to provide information about qualified income trusts, sometimes called Miller Trusts, that are necessary to qualify for Medicaid benefits to pay for nursing home costs, when your income is greater than the maximum amount of income allowed to qualify for Medicaid benefits. If you have questions that are not answers through these qualified income trust FAQs, please let us know and we will attempt to find answers for your questions.
1. What is a Qualified Income Trust?
If your income is over the limit ($2,901 monthly for 2025, for each spouse) to qualify for Medicaid long-term care services (including nursing home care), a Qualified Income Trust (QIT) allows you to become eligible by placing income into an account each month that you need Medicaid. The QIT involves a written agreement, setting up a special account and making deposits into the account. You can prepare your irrevocable qualified income trust immediately online, at a fixed cost of $495 by going to our QIT preparation site.
2. Who needs a Qualified Income Trust?
You need a QIT if your income before any deductions (such as taxes, Medicare, or health insurance premiums) is over the limit to qualify ($2,901 monthly for 2025, or $5,802 if both spouses are seeking long term care Medicaid benefits) for the Institutional Care Program (ICP), Institutional Hospice, Program of All-Inclusive Care for the Elderly (PACE) or the Home and Community Based Services (HCBS) waivers.
3. How do I set up a Qualified Income Trust agreement?
You may obtain professional help from an experienced elder law attorney or Medicaid planning lawyer to set up the QIT agreement, but it is not required. A qualified income trust agreement must meet specific requirements and be approved by Department of Children and Families legal offices. You must submit a copy of the QIT agreement to an eligibility specialist who will forward it to our legal offices for review. You can prepare your QIT online by going to our document preparation site.
4. What items must be included in the Qualified Income Trust agreement?
The qualified income trust agreement must:
- Be irrevocable (cannot be canceled).
- Require that the State will receive all funds remaining in the trust at the time of your death (up to the amount of Medicaid benefits paid on your behalf).
- Consist of your income only. (Do not include or add assets).
- Be signed and dated by you, your spouse, or a person who has legal authority (as legal guardian or pursuant to a durable power of attorney) to act on your behalf or who is acting at your request or the request of your spouse. If the authority is through a durable power of attorney, the durable power of attorney must specifically provide that your agent, or attorney in fact, has the authority to establish trusts on your behalf. You should review your durable power of attorney to determine if it has the appropriate provisions. If you need a durable power of attorney that has the legally acceptable language to establish a QIT, you can prepare one at our site by clicking here.
5. How does the Qualified Income Trust account work?
After setting up the account, you must make deposits into the qualified income trust account every month for as long as you need Medicaid. This means you may need to make deposits before a Medicaid application is approved if you need Medicaid coverage. You cannot make deposits for a past or future month. Any income you receive back from the trust to you will be counted as income to you. If you fail to make a deposit in any given month, or to deposit enough income you will be ineligible for Medicaid payment of long- term care services for the month. As long you deposit income into the QIT account in the month it is received, it will not be counted when we determine if you are eligible for Medicaid for that month.
6. How much income must I deposit into the Qualified Income Trust account?
You must deposit enough income into the qualified income trust account each month so that your income outside the QIT account is within program standards.
7. It is better to deposit more income than take the chance of depositing too little to qualify for Medicaid?
Call (866) 762-2237 or visit http://www.dcf.state.fl.us/programs/access/docs/ssi_fin_elig_chart.pdf for information about current income standards. Our Florida Medicaid lawyer and elder law attorney can assist you with current income standards for Medicaid, as well as assistance with developing a spend down plan to protect and preserve family assets without creating ineligibility for Medicaid benefits. To schedule a consultation to see how we can help you, please call us at (904) 448-1969 in Jacksonville, or Contact Us.
8. What happens to the income I deposit in the Qualified Income Trust account?
The income you have in and out of the qualified income trust is used to calculate your patient responsibility. If you do have a patient responsibility, you are responsible for paying that amount. If there is money left in the QIT upon the death of the Medicaid beneficiary, it is paid to the State, up to an amount equal to the total medical assistance paid on your behalf by the state.
Prepare My Florida Qualified Income Trust Right Here, Right Now - Click Here9. How do I pay funds remaining in the QIT to the State?
The QIT trustee or other individual acting on your behalf should contact the long term care facility to see if any refund for the month of death is due back to the trust. The balance of the QIT at the date of death, plus any refund from the long term care facility is to be paid to the State.
Mail a check payable to the “Agency for Health Care Administration” to:
Florida Medicaid TPL Recovery Program
PO Box 12188
Tallahassee, FL 32317-2188
A brief cover letter or note should state that the payment is for a QIT and include the recipient's name, Social Security number, and/or Medicaid ID number. Enclose a copy of the QIT bank statement covering the date of death to confirm the check is for the balance. Also, include documentation of any refunds received from the long term care facility. Contact ACS at (877) 357-3268 for questions regarding payment of QIT funds to the State of Florida. We hope these qualified income trust FAQs have been useful and informative for you.