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A Miller Trust allows an individual to become eligible for Medicaid by transferring income into a separate bank account.

A Miller Trust is a “legal fiction” that may be required if an individual’s gross income exceeds the 2015 limit of $2,349 per month. A Miller Trust is an “income only trust,” meaning no resources (e.g., existing cash) can be placed in the trust nor can anyone other than the Medicaid applicant place income into it. As such, this trust must only be composed of pension, Social Security, and other gross income of the Medicaid recipient, and it must have a payback provision whereby the State of Florida is the first beneficiary. This provision ensures that the state receives an amount equal to the funds the state paid on behalf of the Medicaid recipient. The trustee must manage the administration and expenditures of the trust in accordance with both federal and state law. The beneficiary, beneficiary’s legal guardian or the beneficiary’s agent with a properly executed power of attorney can establish a Miller Trust.

The following is an example of how a Miller Trust works:

Mrs. Caid has gross income of $3,349 per month, which is in excess of the 2020 limit of $2,349 per month in order to qualify for Medicaid. Mrs. Smith could establish a Miller Trust and place the difference ($1,000) in the trust bringing Mrs. Caid’s income below the income cap of $2,349.

Here is a non-exclusive list of Miller Trust best practices:

  1. Checks must be deposited in their entirety to the bank account;
  2. Income must be deposited first before any funds are withdrawn to pay ANY expenses;
  3. Only certain expenses are allowed to be paid directly from the Miller Trust account;
    • These include the Maintenance Needs Allowance; CSRA; health premiums; uncovered medical expenses; and cost share.
  4. Retain documentation that the funds were deposited into the trust account (e.g., bank deposit slip);
  5. Do not commingle funds (i.e., do not deposit anyone funds belonging to anyone else in the account including your spouse); and
  6. Seek the help of a qualified Elder Law attorney.

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