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Miller Trust Guide
ID · Guide

What Can an Income Trust Pay For in Idaho?

Idaho publishes no trust form. Its rule says income put into the trust must be used to pay patient liability (nursing facility) or participant participation (home and community-based services). Patient liability is figured on total income, including trust deposits, after deductions taken in a set order, among them a $40 personal needs allowance and up to $25 a month paid to the trustee. Every item below is cited to IDHW's own published rules; where IDHW says nothing about an item, this page says so instead of filling the gap. This guide is informational only and is not legal or financial advice.

Income goes into an Idaho Income Trust each month, and the trustee may pay it out only for the purposes IDHW allows. Paying for anything else can put eligibility at risk. Here is the list, with the IDHW source for each item.

What IDHW's rules allow

  • Patient liability or participant participation

    Income transferred to the trust must be used to pay patient liability or participant participation.

    Source: IDAPA 16.03.05.872.02.d

  • Personal needs

    $40 a month.

    Source: IDAPA 16.03.05.723.03.f

  • Trust fees

    Up to $25 a month paid to the trustee for administering the trust.

    Source: IDAPA 16.03.05.723.03.m

  • Guardian fees

    Guardian fees as the rule allows; when the guardian and trustee are the same person, guardian and trust fees together can't exceed $25 a month.

    Source: IDAPA 16.03.05.723.03.l

  • Health insurance premiums and costs

    Medicare and other health insurance premiums, deductibles and coinsurance not paid by a third party; Medicare Part B premiums only for the first two months of Medicaid eligibility.

    Source: IDAPA 16.03.05.723.03.j

  • Home maintenance

    $212 is subtracted for home maintenance when the rule's conditions are met; it is a deduction only, and no actual payment can be made to maintain the home.

    Source: IDAPA 16.03.05.723.03.h

  • Family member in the home

    A maintenance need deduction for a family member living in the participant's home.

    Source: IDAPA 16.03.05.723.03.i

  • Community spouse allowance

    Subtracted as actually paid to the community spouse, up to the computed maximum.

    Source: IDAPA 16.03.05.725.03

  • Medical costs not covered

    Current medical expenses not covered by Idaho Medicaid or a third party, and medical expenses incurred in the three months before the application month.

    Source: IDAPA 16.03.05.723.03.p and .q

The order payments are made in

Idaho's rule says the deductions "must be subtracted in the order listed" (IDAPA 16.03.05.723.03): personal needs comes before home maintenance, family maintenance, insurance premiums, mandatory income taxes, guardian fees and trust fees, with medical expenses last. The community spouse allowance is applied under section 725.

Trustee and bank fees

Up to $25 a month paid to the trustee for administering the trust is deducted (IDAPA 16.03.05.723.03.m). If the guardian and trustee are the same person, guardian and trust fees together can't exceed $25 a month.

What the trust can't be used for

Income paid into the trust and not used for patient liability is subject to the asset transfer penalty, with limited exceptions (IDAPA 16.03.05.720.04.e and 872.02.d). Idaho's rule frames most of these items as deductions in the patient-liability budget rather than as trust payments; trust fees are the one item it describes as paid to the trustee.

Timing, and money left over

Income placed into the trust in the same calendar month it is received isn't counted for long-term-care eligibility, but it is counted as income for patient liability or participant participation (IDAPA 16.03.05.872.02.b).

Keeping the monthly record

The trustee is the one who has to show that the trust paid only these items. A month-by-month record of every deposit and every payment, checked against the bank statement, is what makes that easy to show when IDHW asks.

Related: who can be the trustee in Idaho, what happens to the money at death, and the Miller Trust trustee guide for how the monthly cycle works in every state.

Trust not open yet? The account comes first

None of these payments can start until the trust account exists, and most branches have never opened one. Free one-pager: the questions to ask before you drive to a branch, emailed now. Then 4 more short emails over the next 10 days — then we stop.

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Common questions

What can an Idaho Income Trust pay for?
Idaho publishes no trust form. Its rule says income put into the trust must be used to pay patient liability (nursing facility) or participant participation (home and community-based services). Patient liability is figured on total income, including trust deposits, after deductions taken in a set order, among them a $40 personal needs allowance and up to $25 a month paid to the trustee. The items IDHW's rules name: Patient liability or participant participation; Personal needs; Trust fees; Guardian fees; Health insurance premiums and costs; Home maintenance; Family member in the home; Community spouse allowance; Medical costs not covered.
Can the trustee be paid from an Idaho Income Trust?
Up to $25 a month paid to the trustee for administering the trust is deducted (IDAPA 16.03.05.723.03.m). If the guardian and trustee are the same person, guardian and trust fees together can't exceed $25 a month.
What are the timing rules for money in an Idaho Income Trust?
Income placed into the trust in the same calendar month it is received isn't counted for long-term-care eligibility, but it is counted as income for patient liability or participant participation (IDAPA 16.03.05.872.02.b).