About this article: This is general educational information. Massingill does not offer Medicaid eligibility planning, Qualified Income Trust or Miller trust services, or Medicaid estate recovery planning. For advice on these issues, consult an attorney who practices Medicaid and elder law. Massingill does not prepare or file tax returns.
A Qualified Income Trust, often called a QIT or Miller trust, may be relevant when someone needs certain Medicaid long-term care benefits but has income above the applicable limit. It is a specialized eligibility tool, not a general estate-planning trust or a way to guarantee benefits.
What a QIT does
Texas treats qualifying income directed into a properly established and administered QIT differently when evaluating certain institutional and waiver programs. The trust must be irrevocable and contain the required state repayment provision. It generally holds the individual’s income, not savings or other assets. A QIT does not resolve every eligibility requirement.
Why administration matters
Signing a trust document alone is insufficient. Deposits, timing, permitted payments, records, and the particular benefit program matter. Income placed in the account can still affect the recipient’s contribution toward care. Families should obtain instructions for their circumstances rather than treating the trust as unrestricted spending money.
Questions to bring to a Medicaid attorney
- Does the requested benefit program permit a QIT?
- Which income sources must be deposited, and when?
- Who will administer the account and retain statements?
- What payments are permitted and what care contribution is required?
- What happens to remaining funds at death?
Bring income statements, benefit notices, bank records, and any existing trust or power of attorney. Ask the attorney to explain both document preparation and ongoing administration, including their separate fees.
For current Texas requirements, see the Texas HHS Qualified Income Trust policy. Do not transfer assets or change deposits based solely on this overview.
Joshua Massingill
Joshua Massingill is an attorney practicing in Austin, Texas. He serves on the Texas State Bar’s Law Practice Management Committee, the Leander Educational Excellence Foundation (LEEF) Board of Directors, and the Success-Werx Board of Advisors. He mentors young entrepreneurs in Leander ISD’s INCubatorEDU program and is active in his church.