What Can a Miller Trust Pay For in Ohio?
Ohio's rule (OAC 5160:1-6-03.2, as amended effective October 12, 2026) sets a fixed order for paying out QIT money within thirty days of each deposit: a personal or maintenance needs allowance, a maintenance allowance for a spouse and any dependents, health care costs including the patient liability owed for long-term care, and up to $15 a month for bank, attorney and other trust expenses. Every item below is cited to ODM's own published rules; where ODM 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 Ohio Miller Trust each month, and the trustee may pay it out only for the purposes ODM allows. Paying for anything else can put eligibility at risk. Here is the list, with the ODM source for each item.
What ODM's rules allow
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Personal or maintenance needs allowance
$75 a month for someone in a medical institution; for HCBS waiver members other than the assisted living waiver, the allowance is the special income maintenance needs allowance (SIMNA).
Source: OAC 5160:1-6-03.2(F); OAC 5160:1-6-07; OAC 5160:1-6-07.1
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Spouse and dependents
A maintenance allowance for a spouse and, when applicable, for family dependents.
Source: OAC 5160:1-6-03.2(F); OAC 5160:1-6-07
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Health care costs, including patient liability
Health care costs under Ohio's patient-liability rules, including income used to help pay for long-term care services.
Source: OAC 5160:1-6-03.2(F)
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Health insurance premiums and cost-sharing
Health insurance premiums (including Medicare and Medicaid premiums), coinsurance, deductibles and copayments incurred by the individual, their spouse, or a minor or disabled child.
Source: OAC 5160:1-6-07
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Medical care Medicaid doesn't cover
Incurred medical expenses recognized under Ohio law but not covered by Medicaid or a third party.
Source: OAC 5160:1-6-07
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Bank, attorney and trust expenses
Up to $15 a month for bank fees, attorney fees, and other expenses required to establish and administer the trust; a larger amount needs ODM approval.
Source: OAC 5160:1-6-03.2(F)
The order payments are made in
OAC 5160:1-6-03.2(F) sets the order: personal or maintenance needs allowance, spouse and dependent allowances, health care costs, then up to $15 for trust expenses.
Trustee and bank fees
Up to $15 a month may be paid from the QIT account for bank fees, attorney fees, and other expenses required to establish and administer the trust; when that isn't enough, the individual can request an increase, which ODM must approve (OAC 5160:1-6-03.2(F)).
What the trust can't be used for
Payments from the QIT other than those the rule authorizes may be treated as a transfer of assets for less than fair market value. Payments made directly to the individual, or to a third party for the individual's food or shelter, count as the individual's unearned income that month (OAC 5160:1-6-03.2).
Timing, and money left over
As amended effective October 12, 2026, the rule requires these payments within thirty days from when the income is placed in the QIT account. ODM's published template still says payments are due by the last day of the calendar month the trust receives the income.
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 ODM asks.
Related: who can be the trustee in Ohio, 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.