What is a Medicaid Qualified Income Trust (QIT)?

A qualified income trust (QIT), also known as a Miller Trust, is an irrevocable trust specially designed to legally divert an individual or married couple’s income into a trust resulting in the income being excluded for purposes of determining eligibility for nursing home Medicaid “institutional care program” (ICP) and Medicaid home and community-based waiver services.

Florida is one of several states which permits the use of a qualified income trust (QIT) when a Medicaid applicant’s income exceeds the Medicaid income cap. In Florida, the income cap (limit) for an individual is 300 percent of the Social Security Income (SSI) benefit rate.  Effective January 1, 2018, the Medicaid income cap for an individual applicant is $2,250.  For a married couple, both of whom are applying for Medicaid, the income cap is doubled. Therefore, effective January 1, 2018, the income cap for married applicants is $4,500 per month.

The QIT is not to be confused with other types of trusts such as a special needs trust, living trust or Medicaid qualifying trust.  The qualified income trust (QIT) serves one purpose – to create a legal pathway to Medicaid eligibility for applicants who have too much income to qualify for assistance but insufficient funds to pay for needed nursing home care.

When a QIT is submitted with an application for Medicaid assistance, the Florida Department of Children and Families (DCF) caseworker assigned to the case is required to forward a copy of the trust instrument in the regional DCF attorney for review. The regional DCF attorney will review the trust to determine if the QIT requirements are contained in the document.