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Miller Trust Guide
OH · Guide Last reviewed

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

To set up a Miller Trust in Ohio, you complete the official ODM 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 Ohio'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 Ohio-licensed elder-law attorney. This guide is informational only and is not legal advice — we explain how to use ODM's own published form; we do not draft it.

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

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

    A Qualified Income Trust only helps when monthly countable income exceeds Ohio'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 ODM QIT template

    Get the model Qualified Income Trust instrument directly from Ohio Department of Medicaid on its .gov site. ODM publishes an approved Qualified Income Trust instrument — an irrevocable declaration of trust naming the Ohio Department of Medicaid as remainder beneficiary — that meets the requirements of OAC 5160:1-6-03.2 when properly completed. 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 ODM 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

    OAC 5160:1-6-03.2 does not itself spell out who may serve as trustee, but the ODM template and Information Packet structure the QIT so the trustee — someone other than the primary beneficiary — controls deposits and disbursements (the packet's example shows checks written by the named trustee).

  5. Open the dedicated trust bank account

    Open a dedicated bank account titled to the trust. A Ohio 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. ODM 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 ODM's rules each month is what keeps benefits from being pulled.

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

Get the official ODM template

Download the model Qualified Income Trust instrument directly from Ohio Department of Medicaid: ODM Qualified Income Trust template . ODM publishes an approved Qualified Income Trust instrument — an irrevocable declaration of trust naming the Ohio Department of Medicaid as remainder beneficiary — that meets the requirements of OAC 5160:1-6-03.2 when properly completed. ODM's QIT Information Packet confirms the published form meets the rule's requirements, while noting a QIT may also be drafted by an attorney. Ohio splits the paperwork into two official documents: the trust instrument itself (linked here) and a separate agency form, ODM 10193 (Qualified Income Trust Verification), that the trustee files with the county department of job and family services along with the signed trust and proof of the QIT account.