Running the trust
What happens to a Florida QIT when the Medicaid recipient dies?
Zacharia Frey PLLC. Updated November 2026. Draft for attorney review.
The balance left in a Florida QIT goes to the State, up to the total Medicaid paid for the person's care; that payback is one of the four terms every Florida QIT must contain. DCF tells families to make the check payable to Florida Medicaid and send it to the Agency for Health Care Administration's third-party liability contractor, with a note giving the person's full name and Social Security or Medicaid number. A QIT is a way to qualify for Medicaid, not a way to pass money to family.
The payback rule
Federal law allows an income trust to be disregarded only if the State will receive all amounts remaining in it at the person's death, up to the total medical assistance paid on their behalf. DCF will not treat a trust as a qualified income trust without that term. Anything left after Medicaid is fully repaid is distributed under the trust's own terms.
How to send the payment
DCF's policy tells staff to advise families to make the check payable to Florida Medicaid and send it to the Agency for Health Care Administration's third-party liability contractor; the mailing address is on DCF Form CF-ES 2356. Include a note with the person's full name and Social Security number or Medicaid number so the payment is credited to the right person. Ask the firm before paying anything else from the trust after death.
Leaving a facility instead
If the person is discharged from a Medicaid facility, they may revoke the income trust if the trust document allows it. If it is revoked, Florida Medicaid must be reimbursed before any other beneficiary receives anything.
If the person moves to home care or assisted living instead, the trust usually continues. The monthly deposit and the patient responsibility must be recalculated for the new setting, and the change must be reported to DCF.
Why the balance should stay small
Every dollar left in the trust at death goes to the State. A growing balance usually means the patient responsibility is not being paid in full or, at home and in assisted living, that the monthly transfer is larger than it needs to be. Fixing that during life is the trustee's job.
Questions
- Does the State take the person's house or other property through the QIT?
- No. The QIT's payback reaches only the money in the trust. Other property is handled under separate rules.
- Who sends the payment to Florida Medicaid?
- The trustee, from the trust account. DCF's instructions are to make the check payable to Florida Medicaid and identify the person by full name and Social Security or Medicaid number.
Where this comes from
- ESS 1840.0110 (income trusts) (DCF ESS Program Policy Manual)
- 42 U.S.C. § 1396p(d)(4)(B) (United States Code)