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Miller Trust Guide
MS · Guide Last reviewed

How to Set Up a Miller Trust in Mississippi: Step by Step

To set up a Miller Trust in Mississippi, you complete the official Mississippi Medicaid Qualified Income Trust template, name a trustee who is not the applicant, open a dedicated trust bank account, and deposit the applicant's income into it in the same calendar month you want coverage to begin. The trust diverts income above Mississippi's $2,982/month long-term-care Medicaid cap (CMS January 2026 figures) so the applicant qualifies. For the core setup this is a paperwork-and-banking task most families handle themselves; for complex estates, consult a Mississippi-licensed elder-law attorney. This guide is informational only and is not legal advice — we explain how to use Mississippi Medicaid's own published form; we do not draft it.

Setting up a Miller Trust in Mississippi is an operational task, not a legal one, as long as you use Mississippi Division of Medicaid's own published template and do not deviate from it. Here is the full sequence, with the Mississippi Medicaid fact behind each step.

  1. Confirm the applicant's income is over the Mississippi cap

    A Qualified Income Trust only helps when monthly countable income exceeds Mississippi's long-term-care Medicaid limit — $2,982/month single, $5,964/month for a couple where both apply (CMS January 2026 figures). If income is under the cap, a Miller Trust usually is not needed.

  2. Download the official Mississippi Medicaid QIT template

    Get the model Qualified Income Trust instrument directly from Mississippi Division of Medicaid on its .gov site. The Mississippi Division of Medicaid (DOM) publishes an official Long-Term Care Income Trust form — Appendix A-8-1, with a companion A-8-2 Help Sheet — for an applicant whose income is over the cap to qualify for nursing-facility or home- and community-based-waiver Medicaid. We never draft or host the trust text — you use the state's own published form.

  3. Fill in the fields the template asks for

    Complete the data fields the Mississippi Medicaid form requests — the applicant's name, date of birth, Social Security number, and each income source (Social Security, pension, and so on) — following the instructions printed on the template.

  4. Name a trustee who is not the applicant

    Mississippi's rule is explicit: the claimant (the Settlor) cannot be the trustee of the Income Trust.

  5. Open the dedicated trust bank account

    Open a dedicated bank account titled to the trust. A Mississippi QIT is set up with the beneficiary's Social Security number — no EIN is required. Branches commonly hesitate, so know what to say before you go.

  6. Fund the trust in the same calendar month

    Deposit enough of the applicant's income into the trust account to bring remaining countable income below $2,982 — in the same calendar month you want coverage to start. Mississippi Medicaid does not back-date, so the month you fund is the earliest month eligibility can begin.

  7. Distribute monthly and keep records

    Each month the trustee pays out only the allowed items (personal-needs allowance, any spousal allowance, medical costs and cost-share) and keeps the named income sources flowing into the account. Staying inside Mississippi Medicaid's rules each month is what keeps benefits from being pulled.

The two steps families get stuck on are opening the bank account in Mississippi and funding the trust before the calendar month closes — see how long setting up a Mississippi Miller Trust takes for the timing rules.

Get the official Mississippi Medicaid template

Download the model Qualified Income Trust instrument directly from Mississippi Division of Medicaid: Mississippi Medicaid Qualified Income Trust template . The Mississippi Division of Medicaid (DOM) publishes an official Long-Term Care Income Trust form — Appendix A-8-1, with a companion A-8-2 Help Sheet — for an applicant whose income is over the cap to qualify for nursing-facility or home- and community-based-waiver Medicaid. It is an income-only trust that names the Division of Medicaid as remainder beneficiary up to the total Medicaid paid, established with the claimant's Social Security number; the trust is governed by Mississippi Administrative Code Title 23, Part 103, Rule 5.17 (Income Trusts) with the forms incorporated at Rule 5.18, and the federal authority is 42 U.S.C. § 1396p(d)(4)(B). HCBS-waiver applicants use the parallel Appendix A-9-1. Mississippi calls it an 'Income Trust' — its version of what is generically called a Miller Trust or Qualified Income Trust. A distinctive Mississippi rule: if the claimant's total income exceeds the facility's private-pay rate for a 31-day month, an income trust cannot restore eligibility. The kit explains how the published form works and links you to DOM's own materials; unlike New Jersey and Indiana, Mississippi does not publish a separate memo to banks.