What Happens to a Miller Trust When the Beneficiary Dies in Georgia?
When the beneficiary of a Georgia Miller Trust dies, money left in the trust does not pass to the family like an ordinary inheritance. The QIT terminates only upon the applicant's death or DCH's express written approval. On death, the trustee stops depositing funds, notifies the county DFCS office and DCH of the reason for termination, and writes a check for the trust balance payable to the 'Georgia Department of Community Health' — up to the total medical assistance Medicaid paid on the applicant's behalf — enclosing a copy of the bank statement and a cover letter identifying the decedent by name, Social Security number, and/or Medicaid number. No other checks are written from the QIT account after death. Per the Trustee Guide (Form 945), the check is mailed to Department of Community Health Third Party Administration, ATTN: Estate Recovery Program, P.O. Box 1984, Atlanta, Georgia 30301-1984; Section 2407 separately routes termination paperwork to the DCH Trust Unit — confirm the current address with DCH at termination, since agency mailing addresses can change. Only funds remaining after DCH is reimbursed pass to the residuary beneficiaries named in the trust. Because most of the applicant's income flows through the trust each month to pay for care, the balance remaining at death is usually small. This guide is informational only and is not legal advice.
Why the money doesn't just pass to the family
A Miller Trust is the mechanism that let the applicant qualify for Medicaid despite income over the CMS January 2026 figures cap of $2,982/month. In exchange, the trust is set up so that whatever remains when the beneficiary dies is first used to reimburse the state for the care Medicaid paid for. That is a condition of using the trust, not a penalty.
Why the trust is irrevocable
A Qualified Income Trust only works if it is irrevocable: the applicant cannot pull the money back out for other purposes, and the trustee can only make the distributions DCH allows. That is what lets the diverted income go uncounted for eligibility.
What's usually left
In practice the balance at death is often small. Most of the applicant's income flows into the trust and back out again each month to pay the personal-needs allowance and the applicant's share of care — so the trust is a pass-through, not a place where money piles up.
What about the house?
The trust payback above is a separate legal channel from Medicaid's broader estate-recovery program, which is what could otherwise reach the applicant's home. Federal law (42 U.S.C. § 1396p(b)(2)) bars a state from pursuing that broader estate recovery — against the home or anything else in the estate — for as long as the applicant has a surviving spouse. That protection is automatic; the surviving spouse does not have to apply for it, and it applies the same way in every state. It also applies while the applicant has a surviving child who is under 21, or blind or disabled at any age.
This is a deferral, not a permanent exemption: once the surviving spouse (and any protected child) has also died, the state may then pursue recovery from what remains of the estate, which can include the home. Couples who want to plan specifically for the home beyond that point should raise it with an elder-law attorney — that's a separate question from the Miller Trust this kit covers. See our full Medicaid estate recovery guide for how the broader program works, the federal protections, and the legitimate ways an attorney can help plan around it.
Before you go to the Georgia bank
Most wasted trips are a bank-procedure problem, not a trust problem. This free one-pager has the questions to ask on the phone before you drive to a branch — emailed now. We'll also send 4 short follow-ups over the next 3 weeks (why most denials are paperwork not eligibility, the trustee role, when to call an attorney) — then we stop. No ongoing newsletter.
Common questions
- Who gets the money left in a Georgia Miller Trust after the beneficiary dies?
- The QIT terminates only upon the applicant's death or DCH's express written approval. On death, the trustee stops depositing funds, notifies the county DFCS office and DCH of the reason for termination, and writes a check for the trust balance payable to the 'Georgia Department of Community Health' — up to the total medical assistance Medicaid paid on the applicant's behalf — enclosing a copy of the bank statement and a cover letter identifying the decedent by name, Social Security number, and/or Medicaid number. No other checks are written from the QIT account after death. Per the Trustee Guide (Form 945), the check is mailed to Department of Community Health Third Party Administration, ATTN: Estate Recovery Program, P.O. Box 1984, Atlanta, Georgia 30301-1984; Section 2407 separately routes termination paperwork to the DCH Trust Unit — confirm the current address with DCH at termination, since agency mailing addresses can change. Only funds remaining after DCH is reimbursed pass to the residuary beneficiaries named in the trust.