Medicaid Long-Term Care
Miller Trusts (Qualified Income Trusts)
Key Points
- Required in income-cap states when income exceeds cap
- Trust must be irrevocable and state-approved
- State inherits any remaining trust balance on death
Watch-Outs
- Not needed in medically-needy or "spend-down" states
Related
Disclaimer: Medicaid rules vary by state and change frequently. Work with an elder-law attorney before making asset-transfer decisions. Not legal or tax advice.
Frequently Asked Questions
How early should I start Medicaid LTC planning?+
At least 5 years before anticipated need — the look-back is 60 months. Earlier is better.
Do I need an elder-law attorney?+
Highly recommended. Medicaid LTC rules are complex, state-specific, and mistakes can create penalty periods of ineligibility.
Does Medicaid pay for my home?+
Medicaid may pay for care regardless of home ownership, but the home is subject to estate recovery after death unless a spouse or disabled child lives there.
What's the difference between Medicare and Medicaid?+
Medicare is federal health insurance for 65+ and disabled. Medicaid is state-federal coverage for low-income people and covers long-term custodial care that Medicare doesn't.