A Pooled Income Trust is an irrevocable trust, administered by a non-profit organization, that lets a person
with monthly income over the Medicaid limit still qualify for home care or community-based Medicaid — the tool
"medically needy"/spend-down states use in place of a Miller Trust. It's only available where a real,
usable non-profit program exists and the state's own rules don't penalize it — not every state qualifies. Pick
your state below.
Don't see your state at all? We've researched every state and most don't currently have a real, DIY-approachable
Pooled Income Trust option — see the FAQ below for why.
Why coverage varies by state
A Pooled Income Trust only makes sense to publish a guide for when three things are all true: a real, active
non-profit organization actually administers one for that state's residents; enrollment is a documented process
a family can complete without an elder-law attorney; and the state's own Medicaid rules don't impose a
transfer-of-assets penalty on contributions from people 65 or older, which would undercut the whole point for
most long-term-care applicants. We check all three against each state's own primary sources before publishing
anything — we don't guess, and we don't publish a guide for a state where the answer turns out to be no.
Frequently asked questions
▸ What is a Pooled Income Trust?
A Pooled Income Trust is an irrevocable trust, administered by a non-profit organization, that lets a person whose monthly income is over the Medicaid limit still qualify for home care or community-based Medicaid — by depositing the excess income into the trust each month instead of keeping it as countable income. Federal law authorizes it at 42 U.S.C. § 1396p(d)(4)(C). Separate sub-accounts are kept for each beneficiary, but the funds are pooled for investment and management purposes.
▸ How is a Pooled Income Trust different from a Miller Trust?
Both solve the same problem — income over a Medicaid limit — but a Miller Trust (Qualified Income Trust) is used in "income-cap" states and is typically drafted for one person and managed by a family member as trustee at an ordinary bank. A Pooled Income Trust is used in "medically needy"/spend-down states that don't offer a Miller Trust at all, is always administered by a non-profit rather than a family member, and generally requires the beneficiary to meet Social Security's disability definition.
▸ Is a Pooled Income Trust available in every state?
No. It depends on whether a state actually has an active, usable non-profit pooled-trust program, whether that state's own Medicaid rules impose a transfer-of-assets penalty on people 65 or older who fund one, and whether enrollment is a documented process a family can complete without an attorney. We only publish a guide for a state once all of that has been checked against primary sources — see the state list below.
▸ Why isn't my state listed yet?
We research every state before publishing anything, and most states don't clear that research: either there's no real non-profit pooled-trust organization serving that state, the state's own Medicaid rules penalize contributions from people 65 or older, or enrollment effectively requires an elder-law attorney rather than being a DIY process. States marked "coming soon" below have cleared that initial screen and are in the build queue; states not listed at all have not.
Miller Trust Guide is an informational publisher, not a law firm — we do not draft trust instruments and are
not affiliated with any pooled trust organization. For advice on your specific situation, consult a licensed
elder-law attorney in your state. Also see What Is a Miller Trust? (the income-cap-state version) →