Miller trust vs. living trust: which one does Florida Medicaid need?

What each trust is for

A Qualified Income Trust exists for one purpose: to let a person whose income is over the limit qualify for long-term care Medicaid. It is irrevocable, it may hold only the person's income, and whatever remains at death goes to the State, up to what Medicaid paid.

A revocable living trust holds property during life and passes it at death without probate. The person who creates it can change or cancel it at any time, which is exactly why Medicaid treats it as theirs.

How DCF treats a revocable trust

For a trust created on or after October 1, 1993 with the person's own assets, DCF considers the entire principal of a revocable trust an available asset, counts any payments that could be made to the person as their income, and treats other payments from the trust as transfers without fair compensation. Putting savings into a living trust does nothing for Medicaid eligibility.

Other irrevocable trusts are different too

An irrevocable trust funded with the person's own assets is not a QIT. If any part of it could be paid to the person or for their benefit, DCF counts that part as available. If nothing could ever be paid to them, the transfer into the trust is reviewed under Medicaid's transfer rules instead. Those are asset-planning questions, separate from the QIT.

Can a person have both?

Yes. Many people who need a QIT already have a living trust from earlier planning. The two do not conflict, but the living trust does nothing to fix an income problem, and the QIT must never receive the living trust's money.

Questions

Is a Miller trust the same as a special needs trust?

No. A Miller trust holds only the person's income so they meet the income limit. Trusts that hold a disabled person's assets are a different kind of trust under different rules.

Will my parent's living trust be a problem for Medicaid?

The assets in it count, the same as if they were in the parent's own name. Whether that matters depends on the asset limit and the planning options, which is a separate conversation from the QIT.