The Short Answer
Florida is an income-cap state: to get nursing-home (ICP) Medicaid, your gross monthly income has to be at or under the cap, about $2,982 a month in 2026. If your Social Security and pension push you over, a Qualified Income Trust (also called a Miller Trust) is the fix. Each month the excess income flows through the trust, so it no longer counts against the cap, and you qualify. Being over income is rarely the real barrier; this is the standard, routine solution.
How It Works
- Each month, enough of your income is routed through the trust to bring your countable income under the cap.
- The trustee uses those funds under strict rules, generally for your share of the nursing-home cost and a small personal needs allowance.
- The trust must be irrevocable and set up correctly, with its own bank account.
- At your death, what remains reimburses the state for the Medicaid it paid.
Because it deals with income rather than transfers, it does not trigger the five-year look-back, so it can be set up quickly even in a crisis.
Told a parent is "over the income limit"?
That is not a wall. Book a free 30-minute consult and we will set up the Miller Trust and move the Medicaid application forward.
Book your free consultIncome Trust vs. Asset Protection Trust
Do not confuse the two. A Qualified Income Trust handles your monthly income to get you under the income cap. A Medicaid asset protection trust handles your assets, the home and savings, to protect them from spend-down. They solve different problems, and some families need both. We sort out which applies as part of Medicaid planning, and you can check your numbers first.
| Qualified Income Trust | Medicaid asset protection trust |
|---|---|
| Deals with income, the monthly money coming in | Deals with assets, the home and savings |
| Gets you under the income cap | Protects them from spend-down |
What It Costs
We prepare a Qualified Income Trust for a flat $750, including the document and getting the trust bank account set up correctly, since a small error can stall a Medicaid approval. It is a modest cost for a tool that opens up coverage worth thousands of dollars a month. We can do it on its own or as part of a full Medicaid application. Check eligibility →
Frequently Asked Questions
What Is a Qualified Income Trust (Miller Trust)?
It is a simple trust that lets someone qualify for Florida nursing-home Medicaid even though their income is over the limit. Florida is an "income-cap" state, so income above the cap (about $2,982 a month in 2026) would normally disqualify you. Each month, the excess income is deposited into the Qualified Income Trust, which means it no longer counts against the cap, and you qualify. It is also called a Miller Trust, and it is one of the most common tools in Florida Medicaid planning.
Who Needs a Miller Trust in Florida?
Anyone applying for nursing-home (ICP) Medicaid whose gross monthly income exceeds the cap. That includes a lot of people whose Social Security and a pension together push them just over the line. Being "over income" feels like a wall, but it is not: the Miller Trust is the standard, well-established fix, and it does not require you to be wealthy or to give anything up. If your income is over the cap, you almost certainly need one.
How Does the Money Work?
Each month, enough of your income is routed through the trust to bring your countable income under the cap. The trustee then uses those funds under strict rules, generally to pay your share of the nursing-home cost and a small personal needs allowance. The trust must be irrevocable and set up correctly, and at your death, whatever remains is used to reimburse the state for the Medicaid it paid. We handle the setup and the bank account so it is done right.
Is a Miller Trust the Same as an Asset Protection Trust?
No, and people mix them up. A Qualified Income Trust deals with income, the monthly money coming in, to get you under the income cap. A Medicaid asset protection trust deals with assets, the home and savings, and protects them from spend-down. They solve different problems, and some families need both. We tell you which one (or both) your situation calls for.
What Does It Cost to Set Up?
We set up a Qualified Income Trust for a flat $750, including the trust document and getting the trust bank account established correctly, because a small setup error can hold up a Medicaid approval. It is a modest cost for the tool that opens up Medicaid coverage worth thousands of dollars a month. We can prepare it as part of a Medicaid application or on its own.
Can You Set It Up Quickly if Care Is Already Needed?
Yes. Miller Trusts come up most often in crisis situations, when a parent is already entering or in a nursing home and the family needs Medicaid now. The trust can be put in place promptly, and unlike asset planning, it does not run into the five-year look-back, because it deals with income, not transfers. If you are racing a nursing-home bill, this is one of the fastest pieces to handle.
Sources of Law
- 42 U.S.C. §1396p(d)(4)(B): Qualified Income Trust (Miller Trust) for income-cap states. Florida ICP income cap (about $2,982/month, 2026; figures change each January). (retrieved 2026-07-11)
- Florida DCF/ESS Policy Manual (income-cap and QIT treatment). Fla. Stat. ch. 736 (Florida Trust Code).
Updated on July 11, 2026. Reviewed by Kevin D. Klagge, Esq., Fla. Bar No. 99502. Attorney Kevin Klagge represents families, businesses, and international clients in estate planning and international law, with a focus on Florida legal tools. He litigates estate and business issues in court. General information about federal and Florida law, not legal advice; 2026 Medicaid figures change annually and eligibility turns on your facts. No attorney-client relationship is created. Do not send confidential information until we have agreed to represent you.