Miller Trusts, also called Qualified Income Trusts, provide a way for Medicaid applicants who have income over Medicaid’s limit to become eligible for Medicaid long term care. … They allow applicants with income over the long-term care Medicaid income limit a way to meet the income limit.

In order to qualify for Medicaid, the applicant’s income must fall below a certain level. Most states allow individuals to spend down any income above this level on their care until they reach the state’s income standard. But in some states, Medicaid applicants who have excess income can qualify for Medicaid only if they put the excess in a special trust, called a “Miller” trust or a “Qualified Income Trust.

The Miller trust can pay the Medicaid recipient a small personal needs allowance, and the trust can also be used to pay the recipient’s spouse a monthly allowance. Any additional money is used to pay the recipient’s share of his or her cost of care. If there is any money left in the trust when the recipient dies, Medicaid has a right to the money to recover the cost of care.

In states that do not have a Medically Needy Program, Medicaid applicants often use a trust to effectively lower their countable income below the state limit. The current income limit in Arkansas is $2,382. Income-only trusts, often called Miller trusts, are trusts that can be established by or for a person of any age, regardless of whether the person is a person with a disability. The trust can be funded only with the person’s income, such as Social Security benefits, pensions, etc. It cannot be funded with assets such as money from a bank account or the sale of stocks or bonds. And, like a special needs trust or pooled trust, a Miller trust must contain a clause that says that upon the death of the person for whom the trust is established, any funds remaining in the trust must be paid to the state Medicaid program, up to the amount the program paid for services on behalf of the person.