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Miller Trust Guide
GA · Guide Last reviewed

What Happens to a Miller Trust When the Beneficiary Dies in Georgia?

When the beneficiary of a Georgia Miller Trust dies, money left in the trust does not pass to the family like an ordinary inheritance. The QIT terminates only upon the applicant's death or DCH's express written approval. On death, the trustee stops depositing funds, notifies the county DFCS office and DCH of the reason for termination, and writes a check for the trust balance payable to the 'Georgia Department of Community Health' — up to the total medical assistance Medicaid paid on the applicant's behalf — enclosing a copy of the bank statement and a cover letter identifying the decedent by name, Social Security number, and/or Medicaid number. No other checks are written from the QIT account after death. Per the Trustee Guide (Form 945) the check is mailed to DCH's Third Party Administration / Estate Recovery Program; Section 2407 routes termination paperwork to the DCH Trust Unit — confirm the current address with DCH at termination. Only funds remaining after DCH is reimbursed pass to the residuary beneficiaries named in the trust. Because most of the applicant's income flows through the trust each month to pay for care, the balance remaining at death is usually small. This guide is informational only and is not legal advice.

Why the money doesn't just pass to the family

A Miller Trust is the mechanism that let the applicant qualify for Medicaid despite income over the CMS January 2026 figures cap of $2,982/month. In exchange, the trust is set up so that whatever remains when the beneficiary dies is first used to reimburse the state for the care Medicaid paid for. That is a condition of using the trust, not a penalty.

Why the trust is irrevocable

A Qualified Income Trust only works if it is irrevocable: the applicant cannot pull the money back out for other purposes, and the trustee can only make the distributions DCH allows. That is what lets the diverted income go uncounted for eligibility.

What's usually left

In practice the balance at death is often small. Most of the applicant's income flows into the trust and back out again each month to pay the personal-needs allowance and the applicant's share of care — so the trust is a pass-through, not a place where money piles up.

Common questions

Who gets the money left in a Georgia Miller Trust after the beneficiary dies?
The QIT terminates only upon the applicant's death or DCH's express written approval. On death, the trustee stops depositing funds, notifies the county DFCS office and DCH of the reason for termination, and writes a check for the trust balance payable to the 'Georgia Department of Community Health' — up to the total medical assistance Medicaid paid on the applicant's behalf — enclosing a copy of the bank statement and a cover letter identifying the decedent by name, Social Security number, and/or Medicaid number. No other checks are written from the QIT account after death. Per the Trustee Guide (Form 945) the check is mailed to DCH's Third Party Administration / Estate Recovery Program; Section 2407 routes termination paperwork to the DCH Trust Unit — confirm the current address with DCH at termination. Only funds remaining after DCH is reimbursed pass to the residuary beneficiaries named in the trust.