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A Miller Trust, also known as a Qualified Income Trust, is a legal arrangement used to qualify Medicaid applicants for long-term care benefits when their income exceeds the eligibility limits set by the government. This type of trust is named after the landmark court case, Miller v. Ibarra, which established the use of such trusts in Medicaid planning.

Well, Do I Need A Miller Trust?

The need for a Miller Trust arises when an individual’s income exceeds the Medicaid eligibility limits for long-term care benefits. In most states, the income limit for Medicaid eligibility is set at 300% of the Supplemental Security Income (SSI) limit, which is $2,382 per month in 2023. If an individual’s monthly income exceeds this limit, they are considered “income ineligible” for Medicaid benefits.

However, if an individual establishes a Miller Trust, their excess income can be deposited into the trust account and still be eligible for Medicaid benefits. The funds in the trust are used to pay for the individual’s medical and long-term care expenses, allowing them to receive the care they need while preserving their assets.

Medicaid Requirements of A Miller Trust

A Miller Trust must meet specific requirements to be considered valid by Medicaid. The trust must be irrevocable, meaning it cannot be changed or revoked once it is established. Additionally, the trust must name the state as the primary beneficiary, meaning any funds remaining in the trust after the individual’s death must be used to reimburse the state for Medicaid benefits paid on their behalf.

The need for a Miller Trust can arise in several situations, including when an individual has a pension, annuity, or other income stream that exceeds the Medicaid income limits. It can also be useful for individuals who receive a lump sum payment, such as an inheritance or a settlement, that would otherwise make them ineligible for Medicaid benefits.

In summary, a Miller Trust is a legal arrangement that allows individuals to qualify for Medicaid benefits when their income exceeds the eligibility limits. By depositing excess income into a trust account, individuals can receive the care they need while preserving their assets. If you or a loved one is facing a situation where a Miller Trust may be necessary, it is important to consult with an attorney (hopefully us, of course) who specializes in Medicaid planning to ensure that the trust is set up correctly and meets all legal requirements.

Costly Mistakes, and How to Avoid Them

By taking the right legal actions, you can protect your family’s key assets and experience peace of mind knowing they’re 100% off-limits – especially regarding the home you grew up in.

As we’ve mentioned, many people squander their hard-earned financial legacy by blindly spending-down. Yes, the $2000 asset limit exists. However, there are proactive steps that can be taken to salvage financial legacy.

Even if your Loved One is already paying the cost of Nursing Home care right now out-of-pocket as a patient, it may not be too late. Please download our FREE eBook today. It will help you to Avoid Costly Mistakes, Qualify For Medicaid & Protect Your Family’s Assets!


By talking about nursing home cost in Arkansas, we have covered some legal topics in this edition and as always, I want to emphasize that (1) the law is different in every state, so if you live in a state other than Arkansas, just know that the law may be totally different in your state; (2) your situation is unique, so one size doesn’t fit all – meaning what we discuss herein may not be right for you; (3) we have purposely over-simplified many of the topics above (otherwise this would be many pages long and unreadable because of all of the legalize).

It is imperative that you meet with your attorney (hopefully us!) and get a plan that will work for you. Don’t try to plan based on what you read in this (or any) article AND don’t try to go it alone. Please consider this, get your questions answered and take action.