How to Set Up a Miller Trust in Nevada: Step by Step
Nevada does not publish a fill-in Qualified Income Trust form. To meet its requirements, an attorney (or, where permitted, you) drafts the trust to satisfy DSS's own published policy, names a trustee, opens a dedicated trust bank account, and funds it with the applicant's income in the same calendar month you want coverage to begin. The trust diverts income above Nevada's $2,982/month long-term-care Medicaid cap (income cap effective 2026 (300% of the SSI Federal Benefit Rate); Personal Needs Allowance effective August 2025 (MAM F-120.5, MTL 08/25) -- Nevada's own published income chart is dated September 2024 and had not been refreshed to 2026 rates as of this kit's research) so the applicant qualifies. For complex estates, consult a Nevada-licensed elder-law attorney. This guide is informational only and is not legal advice — we explain what DSS's policy requires; we do not draft the trust or provide sample trust language.
Nevada does not publish a fill-in Miller Trust form, so the trust is drafted — by an attorney, or by you where permitted — to meet Division of Social Services (DSS), Nevada Department of Human Services -- known until July 2025 as the Division of Welfare and Supportive Services (DWSS)'s own published requirements. Here is the full sequence, with the DSS fact behind each step.
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Confirm the applicant's income is over the Nevada cap
A Qualified Income Trust only helps when monthly countable income exceeds Nevada's long-term-care Medicaid limit — $2,982/month single (income cap effective 2026 (300% of the SSI Federal Benefit Rate); Personal Needs Allowance effective August 2025 (MAM F-120.5, MTL 08/25) -- Nevada's own published income chart is dated September 2024 and had not been refreshed to 2026 rates as of this kit's research). If income is under the cap, a trust usually is not needed.
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Get the required-provisions checklist
Nevada does not publish a fill-in QIT form. DSS's own published policy (Nevada Medical Assistance Manual (MAM), Chapter F-500 "Treatment of Trusts," Section F-520.6 ("Miller Type or Qualified Income Trusts - QITs"), MTL 03/25, effective March 25, 2025; cross-referenced by F-525 (Resources), F-530 (Income), F-540 (Transfer of Assets), F-545 (Eligibility & Payments Review), F-550 (Undue Hardship); federal authority 42 U.S.C. § 1396p(d)(4)(B) and 42 CFR 435.725) instead lists exactly what a compliant trust must contain — the checklist tells you what to bring to an attorney or verify in a draft.
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Have the trust drafted
DSS's MAM F-500 does not state whether a Qualified Income Trust must be attorney-drafted, and no Nevada case or bar opinion specifically addresses QIT kits (see the UPL notes). But because DSS publishes no fill-in instrument, drafting an original trust from the requirements below is, in practice, an attorney task for most families -- self-drafting an original legal instrument carries materially more risk of missing a required clause, including Nevada's distinctive over-funding rule, than filling in an existing state form would. Budget for an attorney; this kit is what keeps that engagement efficient.
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Name a trustee
Nevada's MAM F-500 defines "trustee" generically -- "any individual(s) or entity...
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Open the dedicated trust bank account
Open a dedicated bank account titled to the trust once it is signed. Branches commonly hesitate to open this account type, so know what to say before you go.
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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. DSS does not back-date, so the month you fund is the earliest month eligibility can begin.
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Distribute monthly and keep records
Each month the trustee pays out only the allowed items and keeps records. Staying inside DSS's rules each month is what keeps benefits from being pulled.
The two steps families get stuck on are opening the bank account in Nevada and funding the trust before the calendar month closes — see how long setting up a Nevada Miller Trust takes for the timing rules.
What your Nevada trust must contain
Nevada does not publish a fill-in Qualified Income Trust form. The Division of Social Services (DSS) does not publish a fill-in Qualified Income Trust form. Its Medical Assistance Manual, Section F-520.6 ("Miller Type or Qualified Income Trusts - QITs"), instead lists in detail what a compliant trust must do -- irrevocable, income-only funding, a federally defined list of allowable payments, a bar on trustee/attorney/guardian fees, a state payback clause, and (distinctively) a prohibition on depositing more than the month's actual cost of care -- but attaches no sample or fill-in instrument for applicants to complete. The checklist below is drawn directly from that section, plus F-530 and F-540, clause by clause, so you or your attorney can draft -- or verify a draft against -- a trust that actually satisfies what DSS requires.
The Nevada denial traps that cost families a month of coverage
Most denials are paperwork, not eligibility. This free one-pager lists every DSS denial trap with the citation behind it — emailed now. We'll also send 4 short follow-ups over the next 3 weeks (the bank step, the trustee role, when to call an attorney) — then we stop. No ongoing newsletter.