Income trusts are created for the specific and expressed purpose of helping the individual qualify for Medicaid under his/her specific State mandated criteria.

This trust is especially helpful and, indeed, vital in states that have a set income limit for qualifying for Medicaid. Sometimes referred to as Qualifying Income Trusts, or “Miller Trusts” (based upon a singular court case with the same name), they are used when a Medicaid applicant has income in excess of the required cap and is therefore not eligible for Medicaid, yet concurrently unable to pay privately for nursing home care.

How the Income Trust Works

With an income trust, a significant portion of the money that comes through the trust goes right back out to pay Medicaid for part of the expenses associated with the plan of care.

It bears mentioning that a qualified income trust doesn’t protect income for the Medicare applicant, however without such an income trust the applicant wouldn’t qualify for Medicaid altogether.

For example, if a Medicaid applicant gets a Social Security check for $2,800 but the income cap is $2,100, the applicant wouldn’t qualify for Medicaid. But if the Social Security check is direct-deposited into an income trust, the applicant will qualify for Medicaid, even though much of the $2,800 will be used to pay the applicant’s portion of cost for long-term care.

It is also important to note that Medicaid includes and incorporates gross income into their eligibility criteria, which includes the Medicare Part B premium (typically deducted from the individual’s Social Security checks.)