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Miller Trust Guide

Miller Trust Guide

Set up a Miller Trust before another month of Medicaid coverage is lost.

For adult children, spouses, and the attorneys, paralegals, and care managers who help them.

Most families get here the same way — a caseworker or hospital social worker just said the income is too high, and nobody explained what happens next.

Your state already publishes the form, or the exact rules the trust must follow. It just doesn't come with instructions — this does.

A Miller Trust (Qualified Income Trust, or QIT) is an irrevocable trust used in 24 US income-cap states to qualify a Medicaid applicant whose monthly income exceeds the long-term-care threshold (2026 cap: $2,982/month for a single applicant). 11 of the states we cover publish their own fill-in QIT template on their Medicaid agency site; the rest publish the rules a compliant trust must contain. Our state-specific kit is the step-by-step playbook around what your state publishes — how to fund it, how to open the bank account when the branch refuses, how to redirect Social Security and pension, and how to avoid the denial reasons most families trip on. $97, instant download, money-back if the agency rejects the trust. We are researchers, not attorneys.

Pick your state to start

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Don't see your state? If you're in New York, we don't publish a Miller Trust kit there — New York doesn't offer that mechanism at all. See our New York Pooled Income Trust guide instead, the tool New York uses in its place.

What you get A printable PDF built around your state's own Medicaid rules. Shown: the cover and contents of the Texas kit.

60-second check

Do you even need a Miller Trust?

Most states use the same 2026 long-term-care Medicaid income cap ($2,982 per applicant) — but a couple of states differ, and if both spouses are applying, each one's income is tested separately against this same cap. Pick your state below for the exact figure, or check the general estimate.

Who is applying?

If one spouse is entering care and the other stays at home, choose One person and enter only the income paid in the applicant's own name. The at-home spouse's own income doesn't count here.

Not sure how to total income, or have an unusual situation? See the state guides or read what we do and don't help with. This check runs entirely in your browser — nothing you type is sent or saved. Informational, not legal advice.

What buyers say

Real, verified, and shown here because it's genuine — not a stock quote, not written by us. We only publish testimonials from actual buyers who gave permission.

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

What this is, and why it's built this way

Frequently asked questions

How fast do I get the kit and start the trust?
Instant. The download link arrives by email within minutes of payment. The steps themselves can be done in a few days. The usual holdup is the bank, which is why the kit covers what to say at the branch. If the trust is signed and funded in the same calendar month, coverage can start that month, which stops the private-pay clock.
What does the kit cost and what's the guarantee?
A single-state digital download is $97, one time, backed by two guarantees. Change your mind for any reason within 7 days of purchase and we refund it, no questions asked. If your state Medicaid agency rejects the Qualified Income Trust because of something in the kit, we refund the full purchase price within one business day of hearing about it — you have 30 days from purchase to let us know, and if the agency takes longer than that to decide, tell us anyway: the guarantee still applies once you have the denial. No phone tag, no forms.
When does Medicaid coverage actually begin?
Coverage begins the calendar month the QIT is signed AND funded — both in the same calendar month. There is no back-dating. Every month of delay is another month of full private-pay nursing-home cost ($7,500–$15,000 in most US markets). That is the single biggest reason to start now rather than at the next attorney consult opening.
Why not just hire an elder-law attorney?
You can — and for complex estates (significant assets, prior gifting, second marriages, multi-state property) you probably should. But for the core Miller Trust setup, the work is following a state-published template and opening a specific kind of bank account. Attorneys typically charge $1,000–$2,500 for this. Our kit is $97 and includes the bank-refusal script most attorneys handle themselves but never write down.
What is a Miller Trust?
A Miller Trust (also called a Qualified Income Trust or QIT) is an irrevocable trust used in 24 US "income-cap" states to divert income above the Medicaid long-term-care threshold so the applicant qualifies for nursing-home Medicaid or HCBS waiver benefits. Income deposited into the QIT is not counted by Medicaid when determining eligibility.
Is a Miller Trust the same thing as a Medicaid Asset Protection Trust?
No — they solve different problems. A Miller Trust (Qualified Income Trust) fixes excess income: it lets someone whose monthly income is over the Medicaid limit still qualify. A Medicaid Asset Protection Trust is a different, irrevocable trust used years in advance to shield savings and property from Medicaid's five-year look-back and estate recovery. If your income is over the cap, a Miller Trust is the mechanism. If you're trying to protect assets before ever needing care, that's a separate kind of planning — see our Medicaid Asset Protection Trust guide for how it works and why we explain it rather than sell a kit for it; either way, a licensed elder-law attorney has to draft it.
What is the 2026 Medicaid income limit?
For 2026, the long-term-care Medicaid income limit in most income-cap states is $2,982 per month per applicant, which is 300% of the 2026 Federal Benefit Rate, effective January 1, 2026. If both spouses are applying, each spouse's own income is tested separately against that same $2,982 figure; there is no combined couple limit. A few states differ (Missouri's home-care limit is lower, and Oklahoma also has an upper ceiling), so check your state's page for the exact figure. If your parent's monthly income is above the limit, a Miller Trust is the standard mechanism to qualify.
Which states allow Miller Trusts?
As of October 2026, 24 income-cap states permit Qualified Income Trusts: Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Nevada, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming. Missouri permits them for HCBS waivers only. Louisiana, by contrast, is a spend-down (medically needy) state and does not use a Miller Trust. The full 50-state list, with each state's Medicaid agency source, is at millertrustguide.com/miller-trust-states.
Do you draft the trust document?
No, and that works in your favor. Where your state's Medicaid agency publishes its own Qualified Income Trust template, the kit links you to that official .gov document, so the trust you submit is the version written to the rules your caseworker reviews against, with no third-party wording to second-guess. You download it directly from the agency, and the kit explains how to fill it in, fund it, and keep it compliant month to month. Where a state publishes no template, the guide sets out what that state's law requires the trust to contain, so an attorney's draft can be checked against it. We never write or host trust language ourselves: drafting a trust for a specific person is legal work only a licensed attorney can do.
Is this legal advice?
It's a plain-English guide to your state's own published rules, with a citation behind every step, the same kit for every family in that state. It's informational, not legal advice; if your situation involves other trusts, gifts in the last five years, or significant savings, a licensed elder-law attorney in your state is the right call.

The mistakes that cost families a month of Medicaid coverage

5 short, plain-English emails over 10 days — the funding-month rule, what really happens at the bank, why denials are paperwork not eligibility, what a retired attorney and CPA wrote after using a kit, and the honest signs it's time to call an attorney instead. Then we stop. No ongoing newsletter, no sales list.

Email only — we never ask for income, age, or any detail about your family, and we never sell your address. Privacy policy.

Or explore the map

States in teal have a live guide — click one to open it. Gray states don't use this mechanism at all.

Alaska — view guide Alabama — view guide Arkansas — view guide Arizona — view guide Colorado — view guide Delaware — view guide Florida — view guide Georgia — view guide Iowa — view guide Idaho — view guide Indiana — view guide Kentucky — view guide Missouri — view guide Mississippi — view guide New Jersey — view guide New Mexico — view guide Nevada — view guide Ohio — view guide Oklahoma — view guide Oregon — view guide South Carolina — view guide South Dakota — view guide Tennessee — view guide Texas — view guide Wyoming — view guide
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Browse every state guide

Every state guide includes the bank-refusal script, a monthly funding worksheet and a denial-avoidance checklist. Instant download, money-back if your state's agency rejects the trust.

Don't see your state? If you're in New York, we don't publish a Miller Trust kit there — New York doesn't offer that mechanism at all. See our New York Pooled Income Trust guide instead, the tool New York uses in its place.

Every claim on this site cites a primary state agency document or a recognized source — see our full citation list and editorial process →. Also: What Is a Miller Trust? (the complete guide) → · How to Set Up a Miller Trust → · Medicaid Asset Protection Trust guide → · Medicaid Estate Recovery guide → · Pooled Income Trust guides → · About the author →