What is a Miller Trust?

There are two primary financial criteria for eligibility for Medicaid for nursing home or other long-term care in Georgia.  Medicaid has an asset cap of $2,000 for a single person and $113,560 for a couple in “countable” assets.  Medicaid also has an income cap.  For 2012 the long-term care Medicaid monthly income cap is $2,094/month.  When determining eligibility the caseworker is going to count the entire “gross” monthly income of the applicant.  If the applicant’s income exceeds the cap then the applicant will require a qualified-income trust or miller trust to attain eligibility.

The miller trust is irrevocable and will require the trustee to establish a separate trust bank account.  The trust account can only receive the funds of the applicant.  The trust account cannot directly receive the applicant’s income from it’s source.  The income must first be deposited in the applicant’s checking account and then transferred over to the trust account.  If the miller trust is drafted and established correctly then Medicaid policy states than any money that goes into the trust account does not count as income to the applicant for eligibility purposes.  The Trustee must transfer so much each month to the trust account that the applicant’s income is below $2,094/month.  The trust account also must end each month with a zero balance.  The amount that is transferred in must be paid out before the end of each month.

An applicant must establish a miller trust in Georgia.  A miller trust established in another state cannot be used to qualify for Georgia Medicaid.  If the Medicaid applicant is competent, he or she can execute and establish the miller trust.  If the applicant is not competent, the applicant’s agent pursuant to a valid power of attorney which specifically authorizes the establishment of irrevocable trusts may establish the miller trust.  If the applicant is not competent and does not have a valid power of attorney then a court-appointed conservator is required to establish the miller trust.