Do You Need a Lawyer to Set Up a Qualified Income Trust in Tennessee?
TennCare's policy doesn't say, but because TennCare publishes no fill-in form, the trust has to be drafted from scratch, and most families use an attorney for that. Tennessee publishes no fill-in Qualified Income Trust form, so the trust has to be drafted to meet TennCare's own published requirements. This guide is informational only and is not legal advice.
What usually happens
Tennessee doesn't publish a fill-in form, so the trust has to be drafted to TennCare'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. In Tennessee, coverage can't start before the month the trust is funded, so a month that slips is another month of private-pay nursing care at $9,429–$10,038.
This applies when the person who needs care has gross monthly income over Tennessee's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.
Free: the questions to ask a Tennessee bank before your first visit
7 questions for a five-minute phone call, so you find out whether a branch knows how to open this account before you make the drive. Emailed now, then 4 short follow-ups over the next 10 days — then we stop.
What TennCare's own materials say
TennCare's ABD Trusts policy does not state whether a Qualified Income Trust must be attorney-drafted, and no Tennessee case or bar opinion specifically addresses QIT kits (see the UPL notes). But because TennCare 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 than filling in an existing state form would. Budget for an attorney; this kit is what keeps that engagement efficient.
Why the drafting step is different in Tennessee
Tennessee publishes no fill-in form. Instead, TennCare's policy ( TennCare ABD Manual, Policy No. 110.055, Section 4.h ("Qualified Income Trust (QIT) or Miller Trust"), effective 05/01/2026) lists what a compliant trust has to contain — 8 required provisions — and a trust missing any of them risks a denial. Writing an original legal document to that list is the part families most often hand to an attorney. The requirements walkthrough shows what the list covers.
When families bring in an attorney anyway
The trust itself is one document, but it sits inside a larger Medicaid application. These situations raise questions the trust doesn't answer, and they're where an elder-law attorney's fee usually earns its keep:
- Significant savings or property beyond the applicant's monthly income.
- Gifts or transfers in the last five years, which Medicaid's look-back reviews.
- A spouse still living at home, whose own income and allowances affect the numbers.
- Property or accounts in more than one state.
- An applicant who can't sign for themselves and has no one holding a power of attorney or guardianship. State agencies generally ask whoever signs for the applicant to show that legal authority.
Finding an elder-law attorney in Tennessee
Board of Professional Responsibility of the Supreme Court of Tennessee -- Lawyer Referral Services is the lawyer referral service for Tennessee. Other resources for Tennessee families: Legal Aid of East Tennessee (laet.org) -- free civil legal help for older adults, families, and abuse victims across East Tennessee, including Chattanooga and Knoxville; Memphis Area Legal Services (malsi.org) -- free legal advice and representation for low-income, disabled, and elderly clients in Fayette, Lauderdale, Shelby, and Tipton counties; West Tennessee Legal Services (wtls.org) -- free civil legal aid across West Tennessee; Tennessee Alliance for Legal Services -- Free Senior Legal Helpline (tals.org) -- confidential legal advice for Tennesseans aged 60+ regardless of income or assets, including Medicaid/TennCare questions; Tennessee Area Agencies on Aging and Disability (tn.gov/disability-and-aging) -- the state's regional AAAD/ADRC network, a starting point for local long-term-care and Medicaid options counseling; National Academy of Elder Law Attorneys (NAELA) -- Find a Lawyer directory (naela.org). The National Academy of Elder Law Attorneys also lists its members by state. For what attorneys typically charge, see what it costs in Tennessee.
With or without an attorney, the bank is the next hurdle
Whoever writes or completes the trust, the trustee still has to open the account, 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.