Florida Medicaid · Qualified Income Trusts (Miller Trusts)
Too much income for Medicaid, and not enough to pay for care?
In Florida, a person whose gross monthly income is over the Medicaid income limit cannot get long-term care coverage, no matter how little they own, unless they have a Qualified Income Trust. We help families set one up and run it correctly every month, in a nursing home, at home, in assisted living, or through PACE.
Or email your question to intake@zacfreylaw.com and we will set up a time to talk. Zacharia Frey PLLC, Bonita Springs, Florida.
What a QIT is, in one minute
A Qualified Income Trust is a short, irrevocable trust with its own bank account. Each month, part of the person's income moves from their checking account into the trust. Income in the trust is not counted against the Medicaid income limit, so the person can qualify. From the trust, the trustee pays the monthly share of the cost of care and other allowed expenses. Whatever is left when the person dies goes to the State of Florida, up to what Medicaid paid.
The idea is simple. Running it is where families get into trouble: a missed month, a deposit figured from the net Social Security deposit instead of the gross benefit, or, at home and in assisted living, putting in so much that there is nothing left for rent and groceries.
Zacharia Frey PLLC. Updated November 2026. Draft for attorney review.
What is a Qualified Income Trust
A Florida Qualified Income Trust, or Miller Trust, lets a person whose income is over the Medicaid income limit qualify for long-term care. How it works, who is trustee, and what happens at death.
ReadQIT by care setting
The Florida income limit is the same for nursing home Medicaid, the long-term care waiver, and PACE, but how much to put in the Qualified Income Trust each month is not. Why depositing all income is right in a nursing home and wrong at home or in assisted living.
ReadManaging a QIT
How to run a Florida Qualified Income Trust each month: where income lands, when the transfer moves, which bills the trust pays, keeping checking under the asset limit, and the mistakes that cost Medicaid eligibility.
ReadOut-of-state powers of attorney
Many families move a parent to Florida with a power of attorney from another state. It is usually valid here, but it often does not give the agent authority to create a Qualified Income Trust. What to check and what your options are.
ReadHow we help
We prepare Qualified Income Trusts and check the ones families already have. In a QIT Review, the firm looks at the income, the deductions, the care setting, and the bills, checks them against your documents, and gives you a written monthly plan: how much goes into the trust, which account pays each bill, and the routine to follow.
Questions families ask first
- Who needs a Qualified Income Trust in Florida?
- Anyone applying for Florida long-term care Medicaid, in a nursing home, through the home and community-based waiver at home or in assisted living, or through PACE, whose gross monthly income is over Florida's income limit. Without a QIT that person cannot qualify, even with very few assets.
- Does income over the limit mean my parent can never get Medicaid?
- No. That is what the QIT is for. When the income over the limit is deposited in a properly drafted Qualified Income Trust every month, it is not counted against the limit.
- What is the difference between a QIT and a Miller Trust?
- None. They are two names for the same trust.
Does your family need a QIT?
Three questions, an answer right away, and nothing you type is sent to us. Or write to us with your question and we will set up a time to talk.