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Miller Trust Guide
SD · Requirements Guide

South Dakota Medicaid Income Trust Requirements Guide — Qualify a Family Member for Medicaid Before the Next Billing Cycle

For adult children, spouses, and the attorneys, paralegals, and care managers who help them — before another $9,444–$10,190 month of private-pay care goes by.

A South Dakota Medicaid Income Trust (also called a Miller Trust or Qualified Income Trust) is an irrevocable trust used to qualify a Medicaid applicant whose monthly income exceeds the South Dakota long-term-care income cap of $2,982 per month (effective January 2026). South Dakota does not publish a fill-in QIT form — the trust must be drafted (by an attorney, or by you where permitted) to meet DSS's published requirements (ARSD 67:46:05:33.01 ("Medicaid income trust")). Medicaid eligibility can't start before the month the trust is signed and funded (the trust can't be back-dated), and every month of delay is another month of full private-pay care ($9,444–$10,190/mo in South Dakota). This guide is the requirements checklist and operational walkthrough most families need: $97, instant download, money-back if DSS rejects the trust for a reason traceable to following the guide.

It applies when the person who needs care has gross monthly income over South Dakota's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.

Spouse staying at home?

Only the applicant's own income counts toward this cap, not yours. Separate federal protections keep you from being left without enough to live on: a resource allowance and, when your own income is low, a monthly income allowance. See Medicaid spousal impoverishment protection.

South Dakota doesn't publish a fill-in Qualified Income Trust form, so an attorney drafts it — this is the playbook that keeps that engagement to drafting alone instead of research-plus-drafting: the exact requirements checklist, cited to DSS's own published policy, plus the funding and bank-account mechanics once the trust is signed. Informational only — not legal advice. Every requirement is drawn straight from DSS's own published policy, with the citation behind each claim.

What usually happens

South Dakota doesn't publish a fill-in form, so the trust has to be drafted to DSS's requirements, and an elder-law attorney quotes $1,000–$2,500 to research and draft it. Once it's signed, you take it to the bank, where the branch has never opened one of these and says no. Meanwhile the month is running out. Coverage can't start before the month the trust is funded, so a month that slips is another $9,444–$10,190 of private-pay care. (Source for the funding rule: DSS, ARSD 67:46:05:33.01 ("Medicaid income trust").)

Much of the attorney's fee is research into what DSS requires. This guide is that research, already done: the 6-item required-provisions checklist, cited to DSS's own policy, so the attorney's time goes to drafting. It also covers what comes after signing. South Dakota's rules don't say whether the account needs its own tax ID; these accounts are commonly opened with the applicant's Social Security number. Inside: a word-for-word reply for each bank refusal and a printable letter for the branch manager, a funding worksheet built on the 2026 South Dakota income cap, and the 5 reasons DSS most often denies these, each cited.

You stay in control: you open the account at your own bank, and we never see or touch a dollar of your family's income. Money-back if DSS rejects it, or for any reason within 7 days.

Questions about the guide before you buy? Email support@millertrustguide.com.

  • Built on DSS's own published policy
  • Every claim cited to DSS policy
  • Last verified against DSS on August 29, 2026
  • We never collect your family member's details
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  • Money-back if the trust is rejected

What buyers say

A review from a different state — because it's real, and we'd rather show a genuine reader than fill this page with something invented. Retired attorney & CPA is exactly the kind of reader who'd catch it if this guide were sloppy, which is why we lead with it. We only publish verified customers who gave permission — no invented reviews, no stock quotes.

Your Setup Kit turned out to be extremely useful. It got us to the New Jersey QIT template right away, and that was big. We used the Kit to work through the template and the practical questions about how a QIT actually works, and we were able to draft it, get it executed, open a bank account, and submit it with the application in just two or three days. It was an essential need for us, and the Kit helped us accomplish it very quickly.

Retired attorney & CPA Verified buyer of the New Jersey Kit

Not the only one deciding? Send them this page before you dive in.

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$9,444–$10,190 a month, South Dakota private-pay care

Why this can't wait: until the trust is set up correctly, an over-income applicant can't be approved for Medicaid — so the private-pay bill keeps landing on your family, and your family member's place in care can depend on it. Coverage begins the calendar month the QIT is signed and funded — there is no back-dating — and South Dakota private-pay care runs $9,444–$10,190 a month, so every 30 days of delay is another full month of private-pay bills out of pocket.

The 2026 South Dakota income cap

Income cap, single applicant
$2,982/mo
Personal needs allowance
$100/mo
South Dakota private-pay care
$9,444–10,190/mo

Setting up a Miller Trust in South Dakota starts with one number — the income cap. The South Dakota 2026 Medicaid long-term-care income limit is $2,982/month for a single applicant. If your family member's countable monthly income exceeds this limit, a properly drafted, signed, and funded QIT diverts the excess and brings countable income below the cap. The applicant's Personal Needs Allowance in South Dakota is $100/month. Source: DSS ARSD 67:46:05:33.01 ("Medicaid income trust") [1].

What's in the South Dakota guide

10 operational sections and 3 reference appendices. Here are the six pieces buyers tell other buyers made the difference:

  • The bank-refusal playbook. The single thing buyers tell other buyers about. Most South Dakota branches have never opened a Miller Trust account and refuse on first request. The guide includes a verbatim script citing ARSD 67:46:05:33.01 ("Medicaid income trust") [1], the five most common refusals and how to respond to each, and a one-page resolution letter you can hand to the branch manager.
  • The 5 DSS denial traps and how to avoid each one. Every trap cites the exact DSS policy section behind it, so you can verify before you submit — not after the denial letter arrives.
  • A pre-filled monthly funding worksheet using the 2026 income cap of $2,982 so you know exactly how much income to redirect each month.
  • The 6-item required-provisions checklist, cited to DSS's own published policy — South Dakota doesn't publish a fill-in form, so this is what your attorney's draft must satisfy.
  • The "what to say to family" page — short script for when a sibling asks why you didn't just hire an attorney. Pre-empts the family-conflict fight before it starts.
  • The month-by-month income redirect checklist for after the account opens, so the trust stays compliant every month and Medicaid never has a reason to pull benefits.

“If I'm hiring a lawyer anyway, why do I need this?”

Because South Dakota doesn't publish a fill-in form, the attorney has to draft the trust either way — the question is whether they research DSS's requirements on your bill, or you hand them the requirements up front. This guide is the research: the 6-item checklist, the funding rule, the bank-refusal script, and the 5 DSS denial traps with the citation behind each — everything that turns a research-and-draft engagement into drafting alone.

If your spouse is the one entering care: this guide covers the Qualified Income Trust — the income side of qualifying — in full. If you're the spouse staying at home (the "community spouse"), the guide also walks you through the trust itself, and Section 9 orients you on the separate resource-allowance rules that protect your home and savings. Those resource rules are fact-specific, so for them you'll likely still want a South Dakota elder-law attorney — but the guide's job is to make that a short, cheaper meeting instead of a $1,000–$2,500 one: you walk in with the trust already set up, the resource questions already identified, and the documents already gathered, so you're paying for answers, not for someone to explain the basics to you.

Before you buy

Who this guide isn't for

We'd rather you not buy something you don't need. Skip it if:

  • The income is at or under $2,982/month. A Medicaid Income Trust usually isn't needed. Check the number with the free income-cap check.
  • The obstacle is savings or property, not income. A Medicaid Income Trust only deals with income. See Medicaid asset protection trusts for the asset side.
  • Money or property was given away in the last five years, or other trusts are involved. That needs a South Dakota elder-law attorney.
  • You want someone to handle the whole thing for you. An attorney drafts the trust either way in South Dakota. This guide makes that engagement shorter; it doesn't replace it.

How it works in South Dakota

  1. Confirm income is over the $2,982 cap Gross monthly income, from every source.
  2. Have the trust drafted to DSS's requirements South Dakota doesn't publish a fill-in form.
  3. Name a trustee and open the trust account A dedicated bank account titled to the trust.
  4. Fund it in the same calendar month Eligibility starts that month, never earlier.

Full step-by-step walkthrough →

The funding-month rule

  1. September Trust not funded Private pay: $9,444–$10,190 for the month.
  2. October Sign, open, deposit Trust signed, account opened and income deposited, all this month. Eligible from October.
  3. November onward Deposit every month The income goes into the trust account every month to keep eligibility.

There is no back-dating. Funding in October can't cover September.

What it actually looks like

Sample pages from the guide

Real pages from the South Dakota guide PDF. Click any page to enlarge.

Print-friendly, readable on a phone or tablet, and designed to be taken to the bank. Every operational claim cites a primary state agency or federal source.

How this compares

South Dakota doesn't publish a fill-in QIT form, so an attorney drafts the trust either way. The $97 is for the guide — the requirements checklist and everything around it — that turns the attorney's job into drafting alone, instead of research-and-drafting on your bill.

This guide Attorney alone (no prep) DIY research, no guide Doing nothing
Cost $97 + attorney's drafting fee $1,000–2,500 (research + drafting) $0 upfront — real risk of a rejected trust $0, then $9,444–$10,190/mo private-pay
Time to qualified Faster — drafting only 2–6 weeks (research + drafting) Unpredictable Not until you act
Bank-refusal script Yes Sometimes No n/a
State agency citations Yes n/a If you find them yourself n/a
Updated for the current income cap Yes Yes If you catch the update n/a
"What to say to family" script Yes No No n/a
Delivery time Instant (guide); attorney schedules separately After consult + retainer Instant, but unverified n/a

Attorney costs reflect typical South Dakota elder-law retainers for a Miller Trust setup. Private-pay nursing-home figures reflect recent South Dakota market averages.

The bank step

The bank refusal nobody warns you about

You walk into your branch with the signed trust. The teller calls a manager. The manager has never seen one. They ask for an EIN. They tell you to come back with an attorney. You drive home with an empty trust account and a Medicaid clock ticking.

This is the single most common reason South Dakota families lose a month of benefits, and it has nothing to do with the trust itself — it is a bank-procedure problem. The guide's bank section gives you the exact language to cite at the counter, the DSS policy reference to read aloud, and a printable resolution letter you can hand to the branch manager so they can escalate inside their own bank instead of sending you away.

Refusals the guide walks you through:

  • Branch asks for a tax ID (EIN) for the trust account.
  • Branch is unsure what kind of account this is.
  • Branch has never opened a Medicaid income trust account before.
  • Branch questions who is authorized to sign on the account.
  • Branch questions why the account doesn't hold all of the applicant's income, or why funds are moving out to the facility every month.

Each refusal has a corresponding response in the guide, with the DSS citation behind it.

The thing that saves a second trip: bring the printed DSS policy page to the counter — not just the signed trust. A teller who can read the rule in black and white escalates in minutes; one who only has your word for it sends you home. The guide tells you exactly which page to print and hand across.

If DSS rejects the trust, you pay nothing.

If the denial is for a reason traceable to following the guide, email the agency's stated denial reason to support@millertrustguide.com and we refund the full purchase price within one business day. Report it within 30 days of purchase if you can. If DSS hasn't decided by then, email us anyway: the guarantee still applies once you have the denial. No phone tag, no forms, no fight. Changed your mind for any other reason? You have 7 days, no questions asked. We'd rather lose the sale than make this harder on a family already dealing with enough. Full refund policy.

Avoid these

The 5 most common South Dakota denial reasons

Every denial reason below cites DSS policy. The full guide explains each one in context and the order in which to verify them before submitting the Medicaid application.

Trust funded with resources instead of only income
A Medicaid income trust must be composed only of the beneficiary's own pension, Social Security, or other income -- funding it with resources or assets instead takes it outside this specific mechanism. — ARSD 67:46:05:33.01(1)
Trustee retains discretion over payments to the beneficiary
The rule requires the trustee to pay the beneficiary monthly without option or discretion. A trust that gives the trustee discretion over whether or how much to pay the beneficiary doesn't meet this requirement. — ARSD 67:46:05:33.01(2)
Trust doesn't direct remaining income to the care provider
The trust must direct the trustee to pay remaining trust income monthly to the nursing facility, HCBS, or HCBWS provider to reduce the amount owed by the department. — ARSD 67:46:05:33.01(3)
Missing or defective remainder clause naming DSS
The trust must provide that, on the beneficiary's death and before any other distribution, DSS receives all amounts remaining in the trust up to the total medical assistance paid. — ARSD 67:46:05:33.01(4)
Trust overfunded beyond what's paid out for care
If income placed in the trust exceeds the amount actually paid out of the trust for medical services, the excess is subject to penalties under South Dakota's transfer-of-assets provisions -- the opposite of the usual instinct to divert more income to be safe. — ARSD 67:46:05:33.01 (closing paragraph)

Before you go to the South Dakota bank

Most wasted trips are a bank-procedure problem, not a trust problem. This free one-pager has the questions to ask on the phone before you drive to a branch — emailed now. We'll also send 4 short follow-ups over the next 10 days (what the bank will ask, why denials are paperwork not eligibility, what other buyers found, when to call an attorney) — then we stop. No ongoing newsletter.

Email only — we never ask for income, age, or family details, and never sell your address.

The author

Who's behind this

I'm . I built this guide to close the gap between an attorney-drafted document and a funded Medicaid trust (the short version is up top). I'm not an attorney. I'm a researcher who has now read every DSS policy section that covers Qualified Income Trusts, and I publish what I learned with a citation on every claim. I won't advise you on your specific situation, draft anything, or review a document you or your attorney have drafted; for advice on your situation, you need a South Dakota-licensed attorney.

Questions

Frequently asked questions

Is the South Dakota Medicaid Income Trust Guide legal advice?
No. This guide is informational only and is not legal advice. We are not attorneys and we do not practice law. South Dakota's Department of Social Services does not publish a fill-in trust form, so the guide teaches you exactly what ARSD 67:46:05:33.01 requires a compliant trust to contain, so you can brief an attorney efficiently and verify what they draft. For advice on your specific situation, consult a South Dakota-licensed elder-law attorney.
Does South Dakota provide an official Medicaid income trust form?
No. South Dakota's Department of Social Services (DSS) publishes no fill-in Medicaid income trust instrument. The governing rule, ARSD 67:46:05:33.01, spells out in detail what a compliant trust must do, but attaches no sample or fill-in form. The trust must be drafted, by an attorney or by you where South Dakota law permits, to meet the requirements this guide lays out.
What does the guide include?
A requirements-and-operations guide: the required-provisions checklist derived from ARSD 67:46:05:33.01 with a citation for each item, guidance on gathering what an attorney needs before your first meeting, the monthly funding worksheet, the bank-account walkthrough, and South Dakota-specific denial-avoidance guidance. Delivered as a single PDF.
Do you provide the trust document itself?
No. We never draft or provide sample or model trust language, generic or otherwise -- that would cross from explaining the law into practicing it. The guide tells you exactly what South Dakota requires the finished trust to contain; drafting it is your attorney's work (or, where permitted, your own).
Who needs a Medicaid income trust in South Dakota?
A person applying for South Dakota Medicaid long-term care -- Nursing Facility Medicaid or the HOPE Waiver (home and community-based services) -- whose gross monthly income is above $2,982/month (2026, 300% of the SSI standard). Both programs are tested against the same income standard.
Does all of my income have to go into the trust?
South Dakota's rule describes what happens to income once it's in the trust -- the trustee pays you up to the cap and pays the rest to your care provider -- without stating a floor on how much must be deposited. Notably, South Dakota's rule also penalizes depositing MORE into the trust than what's actually needed to pay for your care. Confirm the right amount with your attorney.
Is South Dakota's Medicaid income cap based on gross or net income, and when is the Medicare Part B premium deducted?
South Dakota's rule defines "income" as any money or in-kind payment "before deductions" (ARSD 67:46:04:02), and the 300%-of-SSI income-cap test for nursing facility and HCBS/HOPE Waiver applicants (ARSD 67:46:04:14) doesn't add any net-income or budgeting qualifier — unlike the separate test for assisted living/adult foster care, which does (ARSD 67:46:04:15). The Medicare Part B premium isn't on South Dakota's list of income exclusions (ARSD 67:46:04:03) and isn't netted out before the income-cap or trust-funding calculation. It's deducted later, as a separate post-eligibility budgeting step alongside the personal needs allowance, when DSS calculates what you owe the facility (ARSD 67:46:06:05, :06, :10). Confirm the calculation for your situation with DSS or your attorney.
After my income goes into the trust, what order does South Dakota pay it out in each month?
Two different waterfalls apply. Inside the trust itself, ARSD 67:46:05:33.01 sets a clear order: the trustee pays you up to the income cap, then pays the remainder to your nursing facility, HCBS, or HCBWS provider, and on your death DSS is paid before any other distribution. Separately, when DSS calculates what you owe the facility each month, its cost-of-care rules (ARSD 67:46:06) subtract a set of allowances from your gross income — the personal needs allowance (ARSD 67:46:06:05), any Medicare or health-insurance premium you pay (ARSD 67:46:06:06), and a dependent or spousal allowance if applicable (ARSD 67:46:06:07, or the spousal-impoverishment rules in ARSD ch. 67:46:07 if you have a community spouse) — and the facility is paid whatever income remains (ARSD 67:46:06:10). South Dakota's rule doesn't rank these deductions in a numbered sequence; it treats them as a formula. Confirm your own calculation with DSS or your attorney.
Does South Dakota have a couple income cap?
No published couple standard exists for the Medicaid income trust -- South Dakota tests each spouse's income individually against the $2,982/month single standard.
Can I be my own trustee in South Dakota?
South Dakota's own rule doesn't say who may or may not serve as trustee -- a genuine silence, not a confirmed answer either way. Confirm trustee eligibility directly with DSS or your drafting attorney before naming one.
Does a South Dakota Medicaid income trust need an EIN?
Generally no. South Dakota's rule doesn't address tax-ID treatment at all. A trust funded only by the individual's own income is usually opened under the individual's own Social Security number. If a bank asks for an EIN out of habit, confirm the titling with your attorney and the bank.
What if my bank refuses to open the trust account?
Bank refusal is common on a first attempt. The signed trust instrument is your documentation: it is a single, dedicated account titled to the trust. The guide walks you through handling first-attempt refusals and escalating to the bank's trust department if needed.
What happens to the trust after the person on Medicaid passes away?
South Dakota DSS is paid everything remaining in the trust, before any other distribution, up to the total medical assistance paid on the individual's behalf.
Do you offer a refund?
Yes -- money back if South Dakota rejects the Medicaid income trust for any reason traceable to following the guide. Email support@millertrustguide.com with the agency's stated denial reason and we issue a full refund within one business day.
Will you talk to me on the phone about my situation?
No. We do not offer phone support and we do not advise on individual situations. For advice on your specific situation, consult a South Dakota-licensed elder-law attorney -- you can find one through the State Bar of South Dakota's Lawyer Referral Service, East River Legal Services, Dakota Plains Legal Services, or Dakota at Home.
Which banks will open a Qualified Income Trust (QIT) bank account in South Dakota?
There's no published list of banks that offer QIT accounts — most retail branches simply haven't opened one before, since it's an uncommon account type, not because anything is wrong with the trust itself. In practice: larger banks (Chase, Wells Fargo, Bank of America) generally have a centralized trust department that can process the request even when a branch teller can't; full-service branches (often a market's main branch) open commercial and trust-style accounts more routinely than limited-service branches; and community banks and credit unions are frequently the most willing, since their account-opening process tends to involve a human review rather than a screen-driven template. ARSD 67:46:05:33.01 does not address tax-ID treatment at all. A trust funded only by the beneficiary's own income is commonly opened using the beneficiary's own Social Security number, consistent with how similar Medicaid income trusts are banked nationally, but this isn't confirmed by South Dakota's own rule. If a branch asks for an EIN out of habit, confirm the account titling with your attorney and the bank. The guide includes the exact script to use at the counter and a printable letter for a branch manager if the first attempt is refused.
When does South Dakota Medicaid coverage begin after the Qualified Income Trust is set up?
Coverage begins the calendar month the QIT is signed, the trust account is opened, and enough of the applicant's income is deposited to bring remaining countable income below the 2026 special income limit of $2,982/month — all in the same calendar month. There is no back-dating, so every month of delay is another month of full private-pay care ($9,444–$10,190/month in South Dakota). Source: DSS ARSD 67:46:05:33.01 ("Medicaid income trust").
Can you set up a South Dakota Miller Trust without a lawyer?
South Dakota requires a license from the Supreme Court and active State Bar membership to practice law (SDCL 16-16-1); no South Dakota case, Attorney General opinion, or bar ethics opinion addressing generic self-help legal-form kits, Medicaid planning, or Medicaid income trusts specifically was found, and South Dakota has no Certified/Licensed Legal Document Preparer safe harbor for nonlawyers. Because DSS publishes no fill-in trust form, producing a compliant Medicaid income trust from the requirements below means drafting an original legal document, which for most people falls on the attorney side of that line. This guide never drafts or reviews your trust language -- it tells you what South Dakota's own rule requires the finished document to contain, so an attorney engagement is efficient and so you can check what they draft against the same list.
Can an attorney, paralegal, or care manager use this guide for a client?
Yes. It explains South Dakota's own published Medicaid Income Trust process in plain language, which works whether you're doing this for your own family member or for a client — professionals handling a case outside their usual specialty use it as a working reference this way. It doesn't replace your own judgment on a specific client's facts and isn't personalized advice; it's the same walkthrough of South Dakota's official form either way. If you expect to use it across more than a handful of clients or want redistribution rights, email support@millertrustguide.com about licensing options.
Do I need a Miller Trust in South Dakota?
It applies when the person who needs long-term-care Medicaid has gross monthly income over South Dakota's income cap of $2,982 (effective January 2026). Count gross income before any deductions: Social Security, pension, annuity and similar income paid in their name. It applies the same way whether you're their child, their spouse, or a professional helping them. If the income is under the cap, a Miller Trust usually isn't needed. If you're the spouse staying at home, only the applicant's own income counts toward this cap, not yours; separate federal protections, a resource allowance and, when your own income is low, a monthly income allowance, keep you from being left without enough to live on.
What if DSS changes its requirements or the income cap after I buy?
If DSS revises its published requirements or policy within 12 months of your purchase, email support@millertrustguide.com and we'll send the updated edition free. This page shows the date it was last verified against DSS (August 29, 2026). The income cap is different: it's a routine yearly adjustment that follows the federal benefit rate each January, DSS publishes the new figure, and you use it in place of the old one; the steps stay the same.

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Keep reading

Step-by-step South Dakota guides

New to this? What Is a Miller Trust? covers the plain-English basics — what it is, why states use different names for it, and how it differs from a Medicaid Asset Protection Trust. Below are the free operational walkthroughs that go deeper on the questions South Dakota families ask most.

Free operational walkthroughs

Primary sources

State agency sources

Last verified against DSS on August 29, 2026. Email support@millertrustguide.com if anything below conflicts with what DSS currently publishes — we correct verified discrepancies within five business days.

Every claim here cites a primary DSS or federal document — see them

Primary state agency sources

  • [1] Policy manual: DSS policy manual (section ARSD 67:46:05:33.01 ("Medicaid income trust"), Title 67 (Social Services), Article 67:46 (Medical Assistance for Family and Children's Programs and for Individuals Age 65 or Older or Disabled), Chapter 67:46:05 (Resources); cross-referenced by 67:46:05:32/32.01 (trust as a resource; establishment of trust), 67:46:05:30 (resource limit), 67:46:04:02/03/14 (income definition, exclusions, and the 300%-SSI income-cap test), and 67:46:06:05/06/07/10 (personal needs, premium, and dependent deductions in the post-eligibility cost-of-care calculation)). This is the source for the required-provisions checklist — South Dakota publishes no separate fill-in template.

Federal sources