Serving as trustee of a Florida QIT

Who serves

Usually a spouse or an adult child, sometimes a trusted friend. The trustee does not need to be a professional, but must be reliable every single month, because a missed or short deposit can cost Medicaid coverage for that month.

Every month

1. 1Confirm that the set amount moved from the recipient's checking account to the QIT account in the same month the income arrived.
2. 2Pay the patient responsibility to the nursing home, the provider the plan designates, or the PACE organization.
3. 3Pay other allowed expenses to third parties, such as health insurance premiums or the allowance for a spouse at home.
4. 4Check the recipient's own accounts before the month ends. Income not spent in the month it arrives becomes an asset the next month, and countable assets must stay within the limit.

Records and quarterly statements

DCF's income trust policy says the trustee must provide quarterly statements identifying the deposits made to the trust for each month. Keep every QIT bank statement and every bill paid from the trust. When DCF reviews the case, those records are how the trustee shows each month was funded and each payment went to a third party for the recipient's benefit.

When something changes

Recompute the monthly transfer whenever income changes, usually each January, and after every DCF notice that changes the patient responsibility. A move matters too: DCF can protect income in the month of admission to or discharge from a facility when that income is needed for food or shelter outside it, which changes what is owed that month.

At death

The trustee pays what remains in the trust to Florida Medicaid, up to the total Medicaid paid. Our guide to what happens at death covers the details. DCF tells families to make the check payable to Florida Medicaid, send it to the Agency for Health Care Administration's third-party liability contractor at the address on Form CF-ES 2356, and include the recipient's full name and Social Security or Medicaid number.

Questions

Can the trustee pay themselves from the QIT?

Ask before paying anyone other than a provider or an allowed third party. The trust exists to pay for the recipient's care, and every payment may be reviewed by DCF.

What if the trustee can no longer serve?

The trust document should name a successor trustee. If it does not, or the successor cannot serve, call us before the next month's deposit is due.