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A Qualified Income Trust (QIT), also known as a Miller Trust, is necessary to receive Medicaid benefits for long-term nursing home care if the income of the Medicaid applicant exceeds the maximum allowable amount.  An attorney is required to set up a Qualified Income Trust.  Only income, not property, may be placed in this trust.  In addition, income must be placed in the trust in the month it was received and it must be spent no later than the month following receipt. While not all income must be placed in the trust, all the income from a particular source must be. For example, if someone receives Social Security benefits and a pension, they could choose to place only the pension proceeds in the trust, but must place the whole amount.  Income in a Miller Trust does not count toward the income cap in determining eligibility.  However, it is considered in determining co-payment for services.  Texas is considered an "income cap" state when determining eligibility for Medicaid nursing home benefits.  Income guidelines change frequently, but Texas has an income cap for nursing home residents.  Nursing home residents whose incomes exceed the monthly cap will not qualify for Medicaid unless an attorney helps with special arrangements.

A Special Needs Trust can be established by a parent, grandparent, legal guardian, or the court, using the client's assets.  An attorney is required to set up a Special Needs Trust.  To qualify as exempt, the trust must benefit someone under age 65 who meets SSI disability criteria.  Normally, this type of trust is used in the settlement of personal injury or malpractice tort litigation.  Property in this trust is not counted as a resource.  Distributions made for medical or social services not included in the state Medicaid program will not be counted as income.  Distributions for food, clothing, shelter, or cash will be counted as income to the client.

Source: Texas Department of Aging and Disability Services