The Coleman Law Firm, PLLC
Attorneys and Counselors at Law
10161 Centurion Parkway, Suite 310
Jacksonville, Florida 32256
Phone:  (904) 448-1969
Fax:  (904) 448-5244
Toll Free:  (888) 492-2468
Email:  info@TheColemanLawFirm.net
Our 30+ Years of Experience Can Help You Achieve Peace of Mind

Estate Planning, Probate, Elder Law, Medicaid Planning, Asset Protection, Wills & Trusts
9250 Baymeadows Road, Suite 450
Jacksonville, Florida 32256
Phone:  (904) 448-1969
Toll Free: (888) 492-2468
Fax:  (904) 448-5244
Email:  Info@TheColemanLawFirm.net

Jacksonville Elder Law Attorney and Lawyer Explains Qualified Income Trust and How to Qualify for Medicaid Benefits to Pay for Nursing Home Costs

The Coleman Law Firm can assist you in the preparation of a qualified income trust ("QIT" or "Miller Trust"), either as a stand alone trust, or as part of an overall Medicaid spend down plan.  You can schedule an appointment with our office, meet with an experienced Florida elder law attorney, and we will prepare your QIT within your time requirements.  Your QIT will allow you, or your family member, to qualify for Medicaid benefits to pay for nursing home costs regardless of whether that person's income exceeds the "Income Cap" established for Medicaid eligibility.  Currently, the income cap in Florida for 2014 is $2,163 per month. 

Accordingly, if you or your family member, who is living in a skilled nursing facility, has income in excess of that amount, a QIT must be established so he or she can qualify for Medicaid nursing home benefits to help pay for the cost of long term care.  For the purpose of determining whether you qualify for Medicaid benefits for nursing home care, the State of Florida includes indemnity payments you receive from long term care insurance as "income."  Accordingly, if your income plus long term care insurance indemnity payments exceed the income cap, then you will need a qualified income or Miller trust.

If you would like to learn more about a qualified income trust, or have such a trust prepared for you or your family member, please call our office to schedule an appointment at 904-448-1969 (toll free 888-492-2468), or email us at Info@TheColemanLawFirm.net.

Qualified Income Trust - FAQs


1.    What is a Qualified Income Trust?

If your income is over the limit ($2,163) 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.

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 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 to set up the QIT agreement, but it is not required. A QIT 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.

4.    What items must be included in the Qualified Income Trust agreement?

The QIT 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.

5.    How does the Qualified Income Trust account work?

After setting up the account, you must make deposits into the QIT 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 QIT 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 .

8.    What happens to the income I deposit in the Qualified Income Trust account?

The income you have in and out of the QIT 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 your death, it is paid to the State, up to an amount equal to the total medical assistance paid on your behalf by the state.

9.    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: 
Xerox State Healthcare, LLC 
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 recipients 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.