Skip to content
Miller Trust Guide
TN · Guide Last reviewed

Who Can Be the Trustee of a Miller Trust in Tennessee?

In Tennessee, the trustee of a Miller Trust (Qualified Income Trust) is whoever manages the trust account — depositing the applicant's income each month and paying out only what TennCare allows. TennCare's ABD Trusts policy (110.055) never explicitly states that the trustee must be someone other than the individual -- it consistently treats "trustee" and "individual"/"grantor" as separate roles throughout ("the trustee shall distribute," "the trustee or a court... shall have the right to modify"), but doesn't spell out a bar on self-trusteeship in so many words. A Tennessee legal-aid resource (help4tn.org, a program of the Tennessee Alliance for Legal Services) states directly that the Trustee must be someone other than the applicant -- consistent with general trust law's caution against a sole beneficiary also serving as sole trustee (the "merger" doctrine, which can collapse a trust back into an ordinary asset), but this is not TennCare's own primary-source language. Confirm the trustee question directly with your drafting attorney -- this kit does not treat self-trusteeship as either explicitly permitted or explicitly barred by the state's own policy text. The trustee does not have to be a lawyer or a professional; for the core setup this is a role most families fill themselves. For a complex situation, consult a Tennessee-licensed elder-law attorney. This guide is informational only and is not legal advice.

The trustee does not have to be an attorney or a professional fiduciary. Managing a Qualified Income Trust is an operational job, not a legal one: open the account, move the applicant's income through it each month, and pay out only what TennCare allows — the same short list of tasks every month.

What the trustee does each month

  • Deposits the applicant's income — Social Security, pension, and any other named sources — into the dedicated trust account.
  • Pays out only the amounts TennCare permits: typically the applicant's personal-needs allowance of $70/month, any spousal allowance, and the applicant's share of medical and care costs.
  • Keeps simple records of what went in and what came out, so the trust stays compliant and Medicaid has no reason to question it.

Name a backup trustee

Many families name a successor trustee when they set the trust up, so that if the first trustee cannot continue, the trust keeps running without interruption. Either way the Tennessee setup is the same — see the step-by-step setup and what to say at the bank.

The Tennessee denial traps that cost families a month of coverage

Most denials are paperwork, not eligibility. This free one-pager lists every TennCare denial trap with the citation behind it — emailed now. We'll also send 4 short follow-ups over the next 3 weeks (the bank step, the trustee role, 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.

Common questions

Does the trustee of a Tennessee Miller Trust have to be a lawyer?
No. Managing a Qualified Income Trust is an administrative task — opening the dedicated account, depositing the applicant's income each month, and paying out only the amounts TennCare allows. TennCare's ABD Trusts policy (110.055) never explicitly states that the trustee must be someone other than the individual -- it consistently treats "trustee" and "individual"/"grantor" as separate roles throughout ("the trustee shall distribute," "the trustee or a court... For advice on your specific situation, consult a Tennessee-licensed elder-law attorney.