Unbundled QIT – Miller Trust

Many Medicaid applicants run into the problem of being just a dollar over the income limit of $2,163 per month and they get denied for Medicaid coverage. Although any application may contain several eligibility issues, and this may be the only one that is used by the State to deny the application, over income applicants have an easy fix to this one problem in the form of a Qualified Income Trust (QIT), also known as a Miller Trust. In fact, the need for a QIT is one of the only pieces of advice that it is legal for nursing home personnel to give.

However, use of a Miller Trust form, like the one available from the Health and Human Services Website is not necessarily the best way to implement this solution. The reason is that there are complicated choices to be made in many cases about what sources of income to devote to the trust. Moreover, not all persons can establish a QIT for an applicant and not all instruments, like Powers of Attorney, are sufficient to support a QIT. Finally, since funds devoted to a QIT must be held for the benefit of the applicant first, and then to be paid to the State, most Elder Law attorneys do not recommend that non-attorneys form QIT’s without advice.

This means that the applicant, or more often, the responsible party for the applicant, will need to make an appointment with an attorney, meet with that attorney, the document will need to be drafted and executed, and then implementation will have to be done with a bank BEFORE an application is submitted. Wyatt and Gracey PC announced Monday that it has unbundled its QIT practice. The firm now offers new Online Services whereby a responsible party can make an online appointment for a videoconference with an Elder Law Attorney and at the end of the one-hour can receive a QIT, Instruction package, and sample Letter of Instruction to a bank by email. This service is available to residents throughout Texas.

Scroll to top