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Miller Trust Guide

Miller Trust Guide

Set up a Miller Trust before your parent loses a month of Medicaid coverage.

A Miller Trust (Qualified Income Trust, or QIT) is an irrevocable trust used in 24 US income-cap states to qualify a Medicaid applicant whose monthly income exceeds the long-term-care threshold (2026 cap: $2,982/month for a single applicant). Each state publishes its own QIT template on its Medicaid agency site. Our state-specific kit is the step-by-step playbook around that template — how to fund it, how to open the bank account when the branch refuses, how to redirect Social Security and pension, and how to avoid the denial reasons most families trip on. $129, instant download, money-back if the agency rejects the trust. We are researchers, not attorneys.

Last reviewed . Annual update each January after CMS publishes the new Federal Benefit Rate.

60-second check

Do you even need a Miller Trust?

A Qualified Income Trust only matters if the applicant's monthly income is over the 2026 long-term-care Medicaid cap ($2,982 single, $5,964 couple). Check before you buy anything.

Who is applying?

Not sure how to total income, or have an unusual situation? See the state guides or read what we do and don't help with. This check runs entirely in your browser — nothing you type is sent or saved. Informational, not legal advice.

Pick your state to start

What this is — and what it isn't

Not ready to buy? Start with the free email series.

A handful of short, plain-English emails on how Miller Trusts actually work — the funding-month rule, the bank step, the denial traps. No sales pressure. Unsubscribe anytime.

Email only — we never ask for income, age, or any detail about your family, and we never sell your address. Privacy policy.

Frequently asked questions

How fast do I get the kit and start the trust?
Instant. The download link arrives by email within minutes of payment. Most families have the trust signed, the bank account open, and the first month's income redirected within seven days — fast enough to qualify for the next Medicaid eligibility month and stop the private-pay clock.
What does the kit cost and what's the guarantee?
A single-state digital download is $129. Two-state bundle is $219; three-state bundle is $299. If your state Medicaid agency rejects the Qualified Income Trust for any reason traceable to following the kit, we refund the full purchase price within one business day. No phone tag, no forms.
When does Medicaid coverage actually begin?
Coverage begins the calendar month the QIT is signed AND funded — both in the same calendar month. There is no back-dating. Every month of delay is another month of full private-pay nursing-home cost ($7,500–$15,000 in most US markets). That is the single biggest reason to start now rather than at the next attorney consult opening.
Why not just hire an elder-law attorney?
You can — and for complex estates (significant assets, prior gifting, second marriages, multi-state property) you probably should. But for the core Miller Trust setup, the work is following a state-published template and opening a specific kind of bank account. Attorneys typically charge $1,000–$2,500 for this. Our kit is $129 and includes the bank-refusal script most attorneys handle themselves but never write down.
What is a Miller Trust?
A Miller Trust (also called a Qualified Income Trust or QIT) is an irrevocable trust used in 24 US "income-cap" states to divert income above the Medicaid long-term-care threshold so the applicant qualifies for nursing-home Medicaid or HCBS waiver benefits. Income deposited into the QIT is not counted by Medicaid when determining eligibility.
What is the 2026 Medicaid income limit?
For 2026, the long-term-care Medicaid income limit is $2,982 per month for a single applicant and $5,964 per month for a couple where both spouses are applying. These figures derive from 300% of the 2026 Federal Benefit Rate, effective January 1, 2026. If your parent's monthly income is above this, a Miller Trust is the standard mechanism to qualify.
Which states allow Miller Trusts?
As of December 2025, 24 income-cap states permit Qualified Income Trusts: Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Nevada, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming. Louisiana allows QITs conditionally; Missouri permits them for HCBS waivers only.
Do you draft the trust document?
No. We never author or host trust instrument text. The kit links you to your state's publicly-published Qualified Income Trust template on the state agency .gov website. You download the template directly from the agency. We explain how to use it, how to fund it, and how to keep it compliant month to month.
Is this legal advice?
No. Miller Trust Guide is an informational publisher, not a law firm. We are not attorneys and we do not practice law. We do not customize the kit based on your specific situation. For advice on your specific situation, consult a licensed elder-law attorney in your state.

Editorial sources

Every claim on this site cites a primary state agency document or a recognized source. Selected primary sources:

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