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Miller Trust Guide
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How to Set Up a Miller Trust in South Carolina: Step by Step

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

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

  1. Confirm the applicant's income is over the South Carolina cap

    A Qualified Income Trust only helps when monthly countable income exceeds South Carolina'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 SCDHHS QIT template

    Get the model Qualified Income Trust instrument directly from South Carolina Department of Health and Human Services on its .gov site. South Carolina publishes an official Income Trust Agreement — DHHS Form 905 (January 2026) — the fill-in instrument an applicant completes and returns to the Medicaid office; SCDHHS reviews every completed trust to confirm it meets the legal criteria. 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 SCDHHS 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

    Per DHHS Form 905, the applicant/beneficiary cannot serve as their own trustee — a separate trustee must be appointed (a family member, an attorney-in-fact under a Durable Power of Attorney, a guardian or conservator, or another willing person).

  5. Open the dedicated trust bank account

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

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

Get the official SCDHHS template

Download the model Qualified Income Trust instrument directly from South Carolina Department of Health and Human Services: SCDHHS Qualified Income Trust template . South Carolina publishes an official Income Trust Agreement — DHHS Form 905 (January 2026) — the fill-in instrument an applicant completes and returns to the Medicaid office; SCDHHS reviews every completed trust to confirm it meets the legal criteria. The form states it is not required to use an attorney. A completed Schedule A (DHHS Form 3270 ME) listing the income and the trust bank account is required for the trust's validity, and the trust must be funded solely with income — placing any asset in it renders the trust invalid. Eligibility cannot be established before the month the trust is signed, so it should be completed as soon as possible.