Can You Pay Bills With a Miller Trust?

If your parent or spouse’s gross monthly income is more than the current Medicaid income limit of $2,163 then they need a properly created and administered Miller Trust (also know as a Qualified Income Trust or QIT) in order to have the HHSC disregard their over the limit income. So once they have the required Miller Trust are the funds in the Miller Trust available to pay expenses such as household bills?

Maybe, but rarely.

For an un-married nursing home Medicaid applicant the law requires that their income is applied towards the cost of their care. The only deductions from their income before the rest of it has to be paid to the nursing home are: 1) personal needs allowance; 2) guardianship fees; 3) dependent allowance; and 4) incurred medical expenses. Expenses like mortgage payments, rent, taxes, life insurance premiums, utilities, and other expenses that are not medical cannot be paid from the Miller Trust or the Medicaid applicant’s income unless their income exceeds their nursing home co-payment.

For a married Medicaid applicant the situation is a little different. The deductions that a married Medicaid applicant can take from their income before paying the rest to nursing home are: 1) personal needs allowance; 2) guardianship fees; 3) diversion to meet community spouse’s MMNA; 4) dependent allowance; and 5) incurred medical expenses. So as a result, if the healthy spouse at home’s income is eligible to be increased by diverting all or a portion of the Medicaid applicant’s income then the Miller Trust will pay a specific amount to the healthy spouse each month which can then be used to pay those household bills, but the income should be transferred from the Miller Trust to the spouse first in order to avoid any confusion.

If a married Medicaid applicant’s spouse is not eligible for a diversion of income, then the Miller Trust will not make a payment to the spouse each month and the funds in the trust will be used toward the applicants medical expenses.

In order to establish and maintain nursing home Medicaid eligibility on a monthly basis it is critical that the Medicaid applicant’s income is administered and paid in compliance with Medicaid eligibility regulations. If you do not follow the regulations, you jeopardize Medicaid eligibility for your parent or spouse. Speak with a Woodlands Medicaid Attorney today if you need assistance to obtain nursing home Medicaid for your parent or spouse.