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Miller Trust Guide
DE · Guide

How Long Does It Take to Set Up a Miller Trust in Delaware?

Delaware does not publish a fill-in Qualified Income Trust form, so most of the timeline is attorney drafting and scheduling rather than paperwork — bringing the requirements already compiled (instead of having the attorney research them) is what keeps that part short. The deadline that controls eligibility either way is the calendar month: a Delaware Qualified Income Trust only diverts income in a month where it is signed, has a funded account, and receives enough of the applicant's income to drop countable income below the $2,485/month cap. DHSS/DMMA does not back-date eligibility, so coverage begins the month funding is complete, and every month of delay is another $14,494–$15,132 of private-pay care. The bank is the most common source of delay after that.

The short answer

Delaware does not publish a fill-in form, so most of the timeline is attorney scheduling and drafting, not paperwork — walking in with the requirements checklist already compiled (rather than having the attorney research it) is what keeps that part short. What stretches the timeline after that is opening the bank account and the calendar-month deadline. When the bank balks, it can take a week or more — which is why knowing what to say at the bank up front matters.

The one deadline that actually controls eligibility

A Delaware Qualified Income Trust only diverts income in a calendar month where it is signed, has a funded bank account, and receives enough of the applicant's income to bring remaining countable income below the income cap effective October 1994 (2026 dollar figure); personal needs allowance effective January 2025 cap of $2,485/month — all within that same month. Per DHSS/DMMA 16 Del. Admin. Code Sec 20400.11 ("Income Trusts (Miller Trusts)"), Delaware Social Services Manual (DSSM), Title 16 Sec 20000 (Medicaid Long Term Care); cross-referenced by DSSM Sec 20100.2.2 (250% of SSI income standard), Sec 20620.1 (Personal Needs Allowance), and Sec 20400.1 (trust definitions); federal authority 42 U.S.C. Sec 1396p(d)(4)(B), there is no back-dating: coverage begins the month you complete funding, not the month you started the paperwork.

What slows families down

  • The bank. Most branches have never opened a Qualified Income Trust account and refuse or stall on the first request. This is the single biggest source of delay — and it is avoidable.
  • Trust funded with resources instead of only income. A Miller Trust must be composed only of income. No resources may be used to establish or add to the trust -- including resources voids the trust's Medicaid eligibility entirely, taking the whole trust outside the exemption.
  • Missing or defective state remainder-beneficiary clause. The trust must state that the State of Delaware receives all funds remaining in the trust at the individual's death, up to the total medical assistance paid on their behalf. A missing, weakened, or capped payback clause fails this requirement.

Why the delay is expensive: Delaware private-pay nursing care runs $14,494–$15,132 a month. Because eligibility cannot be back-dated, every calendar month you miss is a five-figure check your family pays out of pocket. The next step is the step-by-step setup.

Before you go to the Delaware bank

Most wasted trips are a bank-procedure problem, not a trust problem. This free one-pager has the questions to ask on the phone before you drive to a branch — emailed now. We'll also send 4 short follow-ups over the next 3 weeks (why most denials are paperwork not eligibility, the trustee role, when to call an attorney) — then we stop. No ongoing newsletter.

Email only — we never ask for income, age, or family details, and never sell your address.

Common questions

When does Delaware Medicaid coverage start after the Miller Trust is set up?
Coverage starts the calendar month the QIT is signed, the account is opened, and enough income is deposited to bring countable income below $2,485/month — all in that same month. DHSS/DMMA does not back-date, so there is no retroactive credit for months before the trust was funded.
Can you speed up setting up a Delaware Miller Trust?
The paperwork itself is quick; the usual bottleneck is the bank, because many branches have never opened a Qualified Income Trust account. Knowing the account type, the no-EIN rule, and what to hand the branch up front is what prevents a multi-week delay.