Who Specifically Needs a Qualified Income Trust?

You'll likely need a QIT if you're a Texas resident seeking nursing home Medicaid and your individual gross monthly income is above $2,982. The Texas Health and Human Services Commission (HHSC) only looks at the applicant's specific income, not the total household income. If only one spouse is applying, only their income counts toward this cap. If both spouses apply, the combined limit for 2026 is $5,964. Setting up this trust provides a predictable path to approval. Our firm focuses on making this process feel effortless by offering fair and predictable flat fees for these services. We prioritize your peace of mind so you can focus on your family instead of technical paperwork. Understanding how a Miller trust for medicaid eligibility operates is easier when you visualize it as a funnel. Your monthly income, including Social Security and pensions, flows into the top of the funnel. Once inside the trust, the funds are distributed for specific, state-approved purposes. This process effectively "lowers" your countable income to meet the Texas limit without requiring you to actually lose that money. It's a precise legal tool that ensures your eligibility remains intact even if your income fluctuates. Every trust involves two primary roles. The beneficiary is the person who needs long-term care and whose income exceeds the limit. The trustee is the person responsible for managing the account, often a spouse or an adult child. The trustee ensures that the correct amount of income is moved into the trust bank account every single month. One important feature to understand is the "payback provision." This rule states that if any funds remain in the trust after the beneficiary passes away, those funds must be used to reimburse the state for the cost of care provided, up to the total amount Medicaid spent.

Can I set up a Miller Trust myself in Texas?

While you could technically try, DIY trusts often fail to meet strict Texas Health and Human Services Commission (HHSC) requirements. A single drafting error can lead to a denied application and thousands of dollars in nursing home costs. We help families in Austin and Round Rock avoid these risks by providing professional drafting. Our firm uses a predictable flat-fee model, so you get reliable legal support without worrying about hourly rates.

What happens to the money left in the Miller Trust after I pass away?

Any funds remaining in the account after the beneficiary passes away are subject to a state "payback provision." This means the state of Texas is reimbursed for the cost of medical care provided through Medicaid. Because the trust is designed to be a monthly pass-through for income, there's usually very little money left in the account at the end of the beneficiary's life. This ensures the trust remains a compliant tool for eligibility.

Who can serve as the Trustee for my Miller Trust?

Any competent adult can serve as the trustee for your Miller Trust, though it's usually a spouse or an adult child. The beneficiary can't serve as their own trustee because they can't have direct control over the "overflow" income. The trustee is responsible for moving funds into the trust account every month and paying the nursing home. Selecting a reliable person is essential for maintaining a valid Miller trust for medicaid eligibility.

Does a Miller Trust protect my house from Medicaid estate recovery?

No, a Miller Trust is strictly designed to solve the "income cap" problem and doesn't protect your home from the Medicaid Estate Recovery Program (MERP). To protect a primary residence in Austin or Leander, you'll need additional estate planning tools like a Lady Bird Deed. We often include these protections as part of a simplified estate plan to ensure your family home remains safe for your heirs while you receive the care you need.

Is there an age limit for establishing a Miller Trust in Texas?

There is no specific age limit for establishing a Qualified Income Trust in Texas. Eligibility is based on your gross monthly income and your medical need for long-term care services rather than how old you are. Whether you're 65 or 95, if your income exceeds the 2026 limit of $2,982, you'll need this legal tool. We provide fair and predictable legal counsel to help seniors of all ages navigate these requirements.

How much income can I put into a Miller Trust?

You can put all of your monthly income into the trust, but you're only required to deposit the amount that exceeds the state limit. Most practitioners recommend depositing the entire check into the Miller trust for medicaid eligibility to avoid accounting errors. After the deposit, the trustee pays out the personal needs allowance and any spousal allowances before the remainder goes to the facility. This structure keeps you compliant with Texas state laws.

Miller Trusts and Texas Medicaid Eligibility: An Educational Guide

Sep 15, 2026 | By Joshua Massingill | Read Time: 2 minutes | Articles

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 Miller trust is another name for a Qualified Income Trust. Families may encounter the term when discussing income limits for Medicaid long-term care. The key question is whether this tool fits the applicant’s benefit program and financial circumstances.

A trust does not guarantee eligibility

Eligibility involves more than income. A Medicaid attorney should assess the relevant financial and nonfinancial requirements and any prior transfers. A Miller trust should not be confused with a revocable living trust, a special needs trust, or a plan to protect a house.

Practical responsibilities to discuss

Before signing documents, identify who will manage the bank account, arrange required deposits, make authorized payments, and keep records. Ask how the arrangement affects payments toward care and what review is needed when income changes. Avoid relying on an online template without advice about the applicant’s actual program.

Preparing for professional advice

Identify the benefit being requested and any application deadline.
Gather income records, account statements, and benefit correspondence.
List who currently has authority to act for the applicant.
Ask what work the attorney’s fee includes and who handles ongoing administration.

The Texas HHS handbook describes the program-specific QIT rules. Use it as background for advice from a Medicaid practitioner, not as a substitute for an individualized eligibility review.

Where Massingill fits

Massingill’s general estate-planning services are separately scoped. They do not include Miller trusts, Medicaid applications or eligibility planning, Medicaid estate recovery strategies, or tax-return preparation. If Medicaid is the reason for seeking a trust, speak with a practitioner who offers that service before proceeding.

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.