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Miller Trust Guide
IN · Guide

What Can a Miller Trust Pay For in Indiana?

Indiana's FSSA template requires the trustee to pay, in a set priority and no later than the last day of the month after the trust receives the income: a personal needs allowance (only if the applicant's entire income goes into the trust), an allowance for a spouse, incurred medical expenses, the cost of medical assistance such as the patient liability, and other payments that won't reduce Medicaid benefits. Every item below is cited to FSSA's own published rules; where FSSA 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 Indiana Miller Trust each month, and the trustee may pay it out only for the purposes FSSA allows. Paying for anything else can put eligibility at risk. Here is the list, with the FSSA source for each item.

What FSSA's rules allow

  • Personal needs allowance

    Paid only if the applicant deposits their entire income into the trust. $52 a month in a nursing facility; for someone on a home and community-based waiver, the allowance equals the Special Income Level. If only the income above the limit is deposited, the allowance doesn't apply.

    Source: FSSA QIT template; IHCPPM 3010.20.10; FSSA instructional packet

  • Allowance for a spouse

    Enough to provide, but not exceed, the spouse's minimum monthly maintenance needs allowance.

    Source: FSSA QIT template

  • Incurred medical expenses

    Incurred medical expenses as the Medicaid program defines them. Indiana's manual lists what qualifies (for example, medical bills from before coverage, non-covered dental care such as dentures, and hearing aids with a written order) and what doesn't (for example, emergency response systems, special diets or supplements, and assisted living room and board).

    Source: FSSA QIT template; IHCPPM 3455.15.10

  • Health insurance premiums

    Premiums for verified health insurance coverage, including Medicare before the state Buy-In begins; indemnity policies don't count.

    Source: IHCPPM 3455.15.10

  • Family allocation

    A family allocation for dependent family members, in the patient-liability budget.

    Source: IHCPPM 3455.15.10

  • Court-ordered guardianship fees

    Up to $35 a month, only if ordered by the court.

    Source: IHCPPM 3455.15.10; FSSA Additional FAQs

  • Cost of medical assistance

    The cost of medical assistance provided to the beneficiary, such as the patient liability.

    Source: FSSA QIT template; IHCPPM 2615.75.15

  • Other payments that won't reduce benefits

    Payments to or for the beneficiary that won't cause a loss or reduction of Medicaid benefits.

    Source: FSSA QIT template

The order payments are made in

FSSA's template sets the priority: personal needs allowance, spouse's allowance, incurred medical expenses, the cost of medical assistance, then other payments that won't reduce benefits. Indiana's policy manual (2615.75.15) lists the first four as payments the trust may include. The premium, family and guardianship items come from Indiana's patient-liability budget rather than the template's own list.

Trustee and bank fees

Indiana's template and policy say nothing about an ongoing trustee or bank fee. FSSA's FAQ says legal and administrative fees for establishing a Miller trust are not currently allowable post-eligibility deductions.

What the trust can't be used for

FSSA's FAQ says the account must be for a single person, hold only monthly deposits of income, and be used only to pay allowable deductions and health care expenses.

Timing, and money left over

Payments are due by the last day of the month after the income reaches the trust (FSSA template). FSSA's memo to banks says almost all funds deposited each month will be used up by the end of the month.

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 FSSA asks.

Related: who can be the trustee in Indiana, 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.

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

Common questions

What can an Indiana Miller Trust pay for?
Indiana's FSSA template requires the trustee to pay, in a set priority and no later than the last day of the month after the trust receives the income: a personal needs allowance (only if the applicant's entire income goes into the trust), an allowance for a spouse, incurred medical expenses, the cost of medical assistance such as the patient liability, and other payments that won't reduce Medicaid benefits. The items FSSA's rules name: Personal needs allowance; Allowance for a spouse; Incurred medical expenses; Health insurance premiums; Family allocation; Court-ordered guardianship fees; Cost of medical assistance; Other payments that won't reduce benefits.
Can the trustee be paid from an Indiana Miller Trust?
Indiana's template and policy say nothing about an ongoing trustee or bank fee. FSSA's FAQ says legal and administrative fees for establishing a Miller trust are not currently allowable post-eligibility deductions.
What are the timing rules for money in an Indiana Miller Trust?
Payments are due by the last day of the month after the income reaches the trust (FSSA template). FSSA's memo to banks says almost all funds deposited each month will be used up by the end of the month.