Understanding Florida’s Qualified Income Trust (Miller Trust) for Medicaid Eligibility

Older adults in Clearwater are often unpleasantly surprised to learn that even a modest monthly income can make them ineligible for Medicaid long-term care benefits. Fortunately, Florida law allows a solution: the Qualified Income Trust, often called a Miller Trust. Our Clearwater elder law attorney explains how setting up this special type of trust can be the key to qualifying for crucial nursing home or assisted living coverage without draining your life savings.

What Is a Qualified Income Trust?

As you get older, long term care costs can quickly add up, depleting all the property and assets you worked hard for over the years. Qualifying for Medicaid helps you get the quality care you need while preventing financial losses. However, under the Florida Administrative Code, Clearwater seniors must meet strict income limits.

The Florida Agency for Health Care Administration (AHCA) reports that in 2025, the income limit for Medicaid Institutional Care Program eligibility is approximately $2,829 per month (subject to annual changes). If your income exceeds the limit even by just a few dollars you are considered ineligible, unless you establish a Qualified Income Trust (QIT).

In general, a trust is a legal arrangement in which you ownership and control of certain assets to someone you trust while naming future beneficiaries. Things to know about Qualified Income or Miller Trust specifically:

• It is an irrevocable trust, meaning once established, it is difficult if not impossible to change;
• It holds the portion of your income above Medicaid’s limit;
• It must be properly funded each month;
• Requires careful compliance to maintain eligibility.

While the AHCA provides general guidance on Miller trusts, professional legal assistance is essential to avoid costly mistakes that could impact your rights to benefits.

How a Miller Trust Helps Older Adults In Clearwater

A properly drafted and managed Miller Trust provides numerous benefits for older adults in Clearwater. It can qualify you for Medicaid despite excess income, provides access to critical care, and helps protect your hard-earned assets.

Creating a Miller Trust is not something you can DIY. Even small mistakes can disqualify you for benefits, potentially costing hundreds of thousands of dollars. To use one effectively, follow these tips:

• Work with an experienced elder law attorney to draft the trust documents;
• Choose the right trustee (often a friend, family member, or a bank);
• Set up a dedicated trust checking account;
• Deposit all excess income into the trust every month;
• Keep meticulous records to satisfy Medicaid’s requirements.

To Discuss Options For Meeting Long-Term Care Costs, Contact Our Experienced Clearwater Elder Law Attorney

Qualifying for Medicaid in Clearwater can help protect your assets while ensuring quality long-term care. However, navigating the system can be overwhelming and denials are common.

As one of only a small number of board-certified elder law attorneys in Florida, William Rambaum has extensive experience helping older adults in Clearwater use strategies such as Miller Trusts to access the care they need. To discuss your options, contact our office today to schedule a consultation with our Clearwater elder law attorney.

Sources:

flrules.org/gateway/readFile.asp?sid=0&tid=0&cno=65A-1&caid=782904&type=4&file=65A-1.doc

ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/long-term-care-program/who-can-receive-long-term-care-services