Florida Medicaid Guide
Qualified Income Trusts (Miller Trusts) in Florida
A Qualified Income Trust, also called a Miller Trust, is the only way a person whose gross income is over Florida's Medicaid cap of $2,982 a month can qualify for long-term care Medicaid. Enough of the applicant's income is deposited into the trust each month to bring the income counted by Medicaid under the cap. The trust must be signed before the month in which eligibility is wanted, it must be funded every single month, and it must be drafted to Florida's requirements. Senior Care Resources coordinates the trust with our affiliated elder law firm and manages the monthly funding as part of the application.
Last reviewed September 6, 2026 by Senior Care Resources. Figures shown are the ones Florida applies as of that date.
Who needs one
Anyone applying for Florida nursing home Medicaid (ICP), assisted living or home care Medicaid (SMMC Long-Term Care), or Hospice Medicaid whose gross monthly income is above $2,982. Gross means before Medicare premiums, taxes, or insurance are taken out. A person with Social Security of $2,200 and a pension of $1,000 has income of $3,200 and needs a trust, even though $3,200 does not come close to paying for a nursing home.
The trust does not make the income disappear. The money in the trust is still used to pay the nursing home as the patient responsibility. What the trust does is satisfy a technical rule so that Medicaid can pay the much larger balance.
What the trust must contain
Florida requires that a Qualified Income Trust:
- be irrevocable;
- hold only the applicant's income (never assets, never a spouse's income);
- name the State of Florida as the first beneficiary of anything left in the trust when the applicant dies, up to the amount Medicaid paid for care;
- have a trustee other than the applicant, usually an adult child or the community spouse; and
- be accompanied by a dedicated bank account in the name of the trust.
DCF reviews the trust document as part of the application. A trust drafted for another state, or a form downloaded from the internet, often fails that review. Drafting the trust is legal work, and in our practice it is done by Zacharia Frey PLLC.
How much to deposit each month
At a minimum, the amount by which gross income exceeds $2,982. Many families deposit one entire income source, for example the whole pension, because a round, consistent deposit is easier to prove and leaves no risk of falling a few dollars short. The money is then paid back out of the trust account to the nursing home as part of the patient responsibility, and the trustee may pay the personal needs allowance of $160 and, where applicable, the community spouse's income allowance from it.
Money must go into the trust in the same month the income is received. Depositing late, or depositing a lump sum to catch up, does not fix a missed month.
The mistake that costs a month of coverage
The trust has to be funded every month, for as long as the person is on Medicaid. If a month is missed, Medicaid does not pay for that month, and the family owes the facility the full private-pay rate for it. There is no cure after the fact.
This happens most often when the applicant has dementia, the trustee is an out-of-state child, and the deposit depends on someone remembering to move money. Set up an automatic transfer on the day the income arrives. We help families do this at approval, and it is the single most valuable ten minutes of the whole process.
Timing
The trust must be signed and funded in the first month for which Medicaid eligibility is sought. If care began in March and the trust is not signed until May, March and April are private pay. This is why an over-income applicant's plan starts with the trust, before anything else.
Frequently asked questions
What is a Qualified Income Trust in Florida?
An irrevocable trust into which a Florida Medicaid applicant deposits enough of their monthly income to bring their countable income under the state's cap of $2,982. It is required for anyone over the cap who wants nursing home, assisted living, home care, or hospice Medicaid. The State of Florida is the remainder beneficiary.
Is a Miller Trust the same as a Qualified Income Trust?
Yes. "Miller Trust" is the informal name, from the court case that created them. Florida DCF calls them Qualified Income Trusts, or QITs, and the two terms mean the same thing.
How much does it cost to set up a Qualified Income Trust in Florida?
The trust is a legal document and is drafted by an attorney. Fees vary by firm; for Senior Care Resources clients it is quoted separately by our affiliated law firm as part of the plan, and the cost is a permitted spend-down expense.
Can the money in a Qualified Income Trust be used for anything?
Only for specific purposes: the patient responsibility owed to the facility, the personal needs allowance of $160, an income allowance for a community spouse or dependent, Medicare and health insurance premiums, and certain medical expenses. It cannot be given to family or saved up.
What happens to a Qualified Income Trust when the person dies?
Any balance left in the trust account goes to the State of Florida, up to the total Medicaid paid for the person's care. In practice the balance is small, because the trust is emptied each month to pay the facility.
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Find out where you stand before you apply
A few questions about income, assets, and care tell us whether your family member is eligible for Florida Medicaid now, what stands in the way if not, and what a plan would look like. Families anywhere in Florida. No cost, no obligation.
This page is general information about Florida Medicaid, not legal advice, and nothing here creates an attorney-client relationship. Medicaid rules change and every family’s facts are different.
Senior Care Resources is a separate company from Zacharia Frey PLLC. Its Medicaid application services are not legal services, and no attorney-client protection applies to them. When an attorney becomes involved, that is a separate legal representation with the law firm.