Ohio Miller Trust Setup Guide — Qualify a Family Member for Medicaid Before the Next Billing Cycle

Before you buy

Who this kit isn't for

We'd rather you not buy something you don't need. Skip it if:

• The income is at or under $2,982/month. A Miller Trust usually isn't needed. Check the number with the free income-cap check.
• The obstacle is savings or property, not income. A Miller Trust only deals with income. See Medicaid asset protection trusts for the asset side.
• Money or property was given away in the last five years, or other trusts are involved. That needs an Ohio elder-law attorney.
• You want someone to fill it in and file it for you. That's what an attorney does. This kit is for doing it yourself, or for checking someone else's work.

The bank step

The bank refusal nobody warns you about

You walk into your branch with the signed trust. The teller calls a manager. The manager has never seen one. They ask for an EIN. They tell you to come back with an attorney. You drive home with an empty trust account and a Medicaid clock ticking.

This is the single most common reason Ohio families lose a month of benefits, and it has nothing to do with the trust itself — it is a bank-procedure problem. The kit's bank section gives you the exact language to cite at the counter, the ODM policy reference to read aloud, and a printable resolution letter you can hand to the branch manager so they can escalate inside their own bank instead of sending you away.

Refusals the kit walks you through:

• Branch requests a tax ID (EIN) for the trust.
• Branch is unsure how to title the account or which document opens it.
• Branch insists on a large opening deposit or minimum balance.
• Branch has never opened a QIT / Miller Trust account.
• Branch instructs the customer to bring an attorney.

Each refusal has a corresponding response in the kit, with the ODM citation behind it.

Avoid these

The 7 most common Ohio denial reasons

Every denial reason below cites ODM policy. The full kit explains each one in context and the order in which to verify them before submitting the Medicaid application.

▸ Not enough income deposited into the QIT in the month eligibility is sought

Ohio only requires that the income above the Special Income Level be diverted — but enough must be deposited that month to bring countable income to or below the limit. Per OAC 5160:1-6-03.2(K), any income that should have been placed into the QIT but was not is considered available to the individual for that month, which makes the applicant over-income and ineligible for that month. There is no back-dating; the QIT must be funded in each month coverage is sought. — OH ODM, OAC 5160:1-6-03.2(K) and (L)

▸ Trust is not irrevocable

OAC 5160:1-6-03.2(D)(1) requires the trust to be irrevocable. A revocable trust, or one that can be revoked through court action, does not meet the requirement and is rejected. — OH ODM, OAC 5160:1-6-03.2(D)(1)

▸ Resources or property other than income deposited into the QIT

Only the individual's own income may be placed into the QIT (plus any interest earned on the trust corpus). Per OAC 5160:1-6-03.2(D)(2) and (D)(5), depositing resources — savings, the proceeds of a sale, gifts, or another person's income such as a spouse's — invalidates the QIT and can push the applicant over the $2,000 resource limit. — OH ODM, OAC 5160:1-6-03.2(D)(2), (D)(5)

▸ Trustee fails to distribute within thirty days of the deposit

Per OAC 5160:1-6-03.2(F), as amended effective October 12, 2026, distributions must be made within thirty days from when the income is placed in the QIT account (ODM's published template, which predates the amendment, still says by the last day of the calendar month). When income placed into the QIT exceeds the amount paid out under paragraph (F), the excess income may be subject to the transfer-of-assets provisions of OAC 5160:1-6-06.5 (paragraph (N)). — OH ODM, OAC 5160:1-6-03.2(F), (N)

▸ Trust administration expenses exceed the $15/month cap without ODM approval

OAC 5160:1-6-03.2(F)(4) lets the trustee pay bank fees, attorney fees, and other expenses to establish and administer the trust only up to fifteen dollars per month. If $15 is not enough, the individual must request — and ODM must approve — a higher amount. Paying more than the approved amount out of the trust is an unauthorized distribution. — OH ODM, OAC 5160:1-6-03.2(F)(4)

▸ Missing or defective State-of-Ohio remainder (payback) clause

Per OAC 5160:1-6-03.2(D)(6), the trust must provide that on the beneficiary's death the remaining trust property is paid to the Ohio Department of Medicaid (or successor) up to the total medical assistance paid, before any other person or creditor. A missing or defective payback clause is a denial cause; the ODM template already contains the required clause. — OH ODM, OAC 5160:1-6-03.2(D)(6)

▸ Unauthorized payment from the trust to the individual or a third party

Distributions other than those authorized in paragraph (F) are penalized: per OAC 5160:1-6-03.2(N) they may be treated as a transfer of assets for less than fair market value; per (O) a payment made directly to the individual, or to a third party for food or shelter, counts as unearned income in the month received; and per (P) any other third-party payment not authorized under (F) or (O) is subject to the transfer-of-assets penalty under OAC 5160:1-6-06.5. — OH ODM, OAC 5160:1-6-03.2(N), (O), (P)

The author

Who's behind this

I'm James Whitfield. I read every ODM policy section on these trusts and tied every step in this kit to the section it comes from, so you can check any of it yourself. I'm a researcher, not an attorney. For advice on your own situation, an Ohio-licensed attorney is the right call.

Questions

Frequently asked questions

▸ Is the Ohio Miller Trust Kit legal advice?

No. This kit is informational only and is not legal advice. We are not attorneys and we do not practice law. The kit teaches you how to use the Ohio Department of Medicaid's publicly-published Qualified Income Trust template and the ODM 10193 verification form. For advice on your specific situation, consult an Ohio-licensed elder-law attorney.

▸ What does the kit include?

A step-by-step operational guide: a plain-English explanation of how an Ohio QIT works, direct links to the official ODM QIT trust instrument and the ODM 10193 verification form, instructions for filling the obvious fields, a monthly funding worksheet, the bank-account walkthrough with a branch-manager script, the month-by-month funding process, and an Ohio-specific list of common denial reasons. Delivered as a single PDF.

▸ Do you provide the trust template itself?

No. We never author or host trust instrument text. The kit links you to the ODM-published template on the State of Ohio's .gov site. You download the template directly from ODM. We explain how to use it, fund it, and keep it compliant.

▸ Who has to set up a QIT in Ohio?

An individual seeking Ohio Medicaid payment of long-term-care services whose gross monthly income is above the Special Income Level ($2,982/month in 2026) must use a Qualified Income Trust to become income-eligible. Resources must also be at or below the $2,000 individual limit. Income at or below the limit does not require a QIT.

▸ Does an Ohio QIT need an EIN?

No. The QIT account is opened using the beneficiary's Social Security number — a separate EIN is not required. The ODM trust instrument and its Certification of Trust both state the trust's identification number is the beneficiary's SSN.

▸ How much of my income goes into the trust?

Only the amount over the Special Income Level needs to be deposited each month. Per ODM's Information Packet, your countable monthly income minus $2,982 (2026) is the amount to place in the trust; if your income varies, the deposit amount can vary. You must fund the QIT every month you want coverage, and the trustee must distribute the funds by the last day of that same month.

▸ When does coverage begin?

The QIT must be funded in the month you are seeking eligibility — there is no back-dating. Per OAC 5160:1-6-03.2(K), any income that should have been placed in the QIT but was not is considered available that month, which makes you over-income for that month. The trust must stay funded every month to keep benefits, and deposits are verified at your annual redetermination.

▸ Is income counted gross or net for Ohio's QIT, and what about the Medicare Part B premium?

Ohio counts income GROSS — before any taxes or deductions — when determining whether you need a QIT and how much to deposit. ODM's Qualified Income Trust Information Packet is explicit: your gross monthly Social Security, pension, and other unearned income is compared to the Special Income Level, and it's the gross amount over that limit that must be deposited into the trust. The Medicare Part B premium is not subtracted at this stage. Instead, it is deducted later, as a specific health-insurance-premium line item in the separate post-eligibility patient-liability (share-of-cost) calculation under OAC 5160:1-6-07 and 5160:1-6-07.1 — after Medicaid eligibility has already been established, when figuring how much of your income goes to the facility versus stays with you.

▸ What is the official order of monthly payments out of an Ohio QIT?

Ohio's rule sets a specific four-tier order, and ODM's own QIT guidance repeats it: (1) a monthly personal needs allowance for the primary beneficiary; (2) a maintenance allowance for the spouse, if any, and for dependent family members, if applicable; (3) health care costs — including nursing-facility or other long-term-care payments — under the post-eligibility patient-liability rules; and (4) up to $15/month for bank fees, attorney fees, and other trust administration expenses (a higher amount requires ODM approval). All distributions must be made within thirty days from when the income is placed in the QIT account (OAC 5160:1-6-03.2(F), as amended effective October 12, 2026); ODM's published template, which predates the amendment, still says by the last day of the calendar month.

▸ What if my bank refuses to open the trust account?

Bank refusal is common on a first attempt. The kit includes a verbatim branch script, the most common refusal types (EIN demand, titling confusion, large-deposit demand, unfamiliarity) and how to respond to each, and the ODM facts that resolve them — the account uses the beneficiary's SSN, is titled as the Qualified Income Trust of the recipient, and is opened with the Certification of Trust rather than the full instrument.

▸ Can I be my own trustee in Ohio?

No. The ODM template and Information Packet structure the QIT so someone other than the primary beneficiary serves as trustee and controls deposits and disbursements. The trustee administers the trust under the Ohio Trust Code, isn't required to post bond, and may be replaced by a named successor trustee.

▸ What happens to the trust after the person on Medicaid passes away?

The QIT terminates on the primary beneficiary's death. Per OAC 5160:1-6-03.2(D)(6), the remaining trust property goes to the Ohio Department of Medicaid up to the total medical assistance paid on the beneficiary's behalf, ahead of any other creditor, through Ohio's Medicaid Estate Recovery process. Only what remains after ODM's claim is paid passes to the beneficiary's estate.

▸ Do you offer a refund?

Yes — money back if ODM rejects the QIT because of something in the kit. Email support@millertrustguide.com within 30 days of purchase with the agency's stated denial reason and we issue a full refund within one business day. If the agency hasn't decided within 30 days, email anyway: the guarantee still applies once you have the denial.

▸ Will you talk to me on the phone about my situation?

No. We do not offer phone support and we do not advise on individual situations. For advice on your specific situation, consult an Ohio-licensed elder-law attorney — you can find one through the Ohio State Bar Association's lawyer referral services or Ohio Legal Help.

▸ Which banks will open a Qualified Income Trust (QIT) bank account in Ohio?

There's no published list of banks that offer QIT accounts — most retail branches simply haven't opened one before, since it's an uncommon account type, not because anything is wrong with the trust itself. In practice: larger banks (Chase, Wells Fargo, Bank of America) generally have a centralized trust department that can process the request even when a branch teller can't; full-service branches (often a market's main branch) open commercial and trust-style accounts more routinely than limited-service branches; and community banks and credit unions are frequently the most willing, since their account-opening process tends to involve a human review rather than a screen-driven template. The QIT account uses the beneficiary's Social Security number — no separate EIN is required. The ODM trust instrument states that the identification number for the QIT is the primary beneficiary's Social Security number, and the attached Certification of Trust (under ORC 5810.13) repeats that the taxpayer identification number for the trust is the beneficiary's SSN. A Miller-type/QIT is a grantor trust reported under the grantor's SSN; banks that ask for an EIN can be shown the trust instrument and the Information Packet's 'Trust Bank Account' section, which directs that the account be established with the recipient's Social Security number. The kit includes the exact script to use at the counter and a printable letter for a branch manager if the first attempt is refused.

▸ Can you set up an Ohio Miller Trust without a lawyer?

For the core Qualified Income Trust setup, the task is following ODM's publicly-published template and opening a specific kind of bank account — work many families do themselves. Attorneys typically charge $1,000–$2,500 for it. For complex situations (significant assets, prior gifting, second marriages, multi-state property), consult an Ohio-licensed elder-law attorney. Miller Trust Guide is informational only and is not legal advice; we do not draft the trust or advise on individual situations.

▸ Can an attorney, paralegal, or care manager use this kit for a client?

Yes. It explains Ohio's own published Miller Trust process in plain language, which works whether you're doing this for your own family member or for a client — professionals handling a case outside their usual specialty use it as a working reference this way. It doesn't replace your own judgment on a specific client's facts and isn't personalized advice; it's the same walkthrough of Ohio's official form either way. If you expect to use it across more than a handful of clients or want redistribution rights, email support@millertrustguide.com about licensing options.

▸ Do I need a Miller Trust in Ohio?

It applies when the person who needs long-term-care Medicaid has gross monthly income over Ohio's income cap of $2,982 (CMS January 2026 figures). Count gross income before any deductions: Social Security, pension, annuity and similar income paid in their name. It applies the same way whether you're their child, their spouse, or a professional helping them. If the income is under the cap, a Miller Trust usually isn't needed. If you're the spouse staying at home, only the applicant's own income counts toward this cap, not yours; separate federal protections, a resource allowance and, when your own income is low, a monthly income allowance, keep you from being left without enough to live on.

▸ What if ODM changes the form or the income cap after I buy?

If ODM revises its form or policy within 12 months of your purchase, email support@millertrustguide.com and we'll send the updated edition free. This page shows the date it was last verified against ODM (October 21, 2026). The income cap is different: it's a routine yearly adjustment that follows the federal benefit rate each January, ODM publishes the new figure, and you use it in place of the old one; the steps stay the same.

Keep reading

Step-by-step Ohio guides

New to this? What Is a Miller Trust? covers the plain-English basics — what it is, why states use different names for it, and how it differs from a Medicaid Asset Protection Trust. Below are the free operational walkthroughs that go deeper on the questions Ohio families ask most.

Primary sources

State agency sources

Last verified against ODM on October 21, 2026. Email support@millertrustguide.com if anything below conflicts with what ODM currently publishes — we correct verified discrepancies within five business days.