In order to be eligible for Medicaid long-term care services, (e.g. to stay in a nursing home paid for by Medicaid) a person’s income must be below the Ohio Medicaid limit. In 2019, this limit is $2,313.00 per month.
If a person receives more than the monthly amount, the excess income can be deposited into a Qualified Income Trust (QIT), sometimes called a “Miller” Trust. Depositing excess income in a QIT permits a person to remain or become eligible for Medicaid long-term care services because Medicaid does not count the income over the limit.
The trust may be established by the individual, the individual’s spouse, a person with legal authority to act for the individual (POA/ guardian) or a person, acting at the direction or upon the request of an individual or the individual’s spouse.
To be valid in Ohio, a QIT must:
- Include only an individual’s own income. It cannot contain a spouse’s income or income from other relatives. It cannot be used for other assets.
- Be irrevocable. Once the trust is established, it cannot be changed or canceled.
- Name the State of Ohio as the beneficiary. The State of Ohio can recover up to the total amount of Medicaid payments made on an individual’s behalf.
Money put in the QIT can be used to pay for the following expenses, but is not limited to this list:
- Patient liability for long term care
- Incurred medical expenses
- Monthly personal or maintenance needs allowance
- Bank fees associated with the maintenance of the Trust
Three forms are associated with this process: