Georgia Nursing Home Medicaid: Setting up a Qualified Income Trust


Our last blog covered the top three things you should know about Georgia Nursing Home Medicaid. Coming in at #1 was:


You likely don’t make too much money to qualify for nursing home Medicaid.


This confuses so many families—and even professionals.


Georgia does have an income cap. By having an income cap for Medicaid eligibility, Georgia is saying that only those that make under $2,313/month (the 2019 income cap) can qualify for Medicaid.


You cannot get Medicaid if your income exceeds $2,313, really?!?

Since most nursing homes cost at least $8,000/month, this creates a huge problem.  Even if you make $5,000/month, where do you get the other $3,000/month to pay for the nursing home?


You can still qualify for Medicaid if you use a Qualified Income Trust also known as a Miller Trust.


Nursing home residents with over $2,313/month of income must jump through an extra hoop in order to qualify for Medicaid benefits. This extra hoop is called the Qualified Income Trust (or the Miller Trust).


How do you set up a Qualified Income Trust?

  1. Secure help with the Medicaid application. Setting up a qualified income trust begins with making sure you meet all of the other Medicaid eligibility requirements and understanding whether you need a Qualified Income Trust or not. You can get help with the application from DFCS, the nursing home business office, or a Certified Elder Law Attorney. Medicaid and QITs are not DIY projects. The costs of any errors or mistakes can be thousands of dollars in unpaid nursing home bills.
  2. Have an attorney draft the Trust document. The Qualified Income Trust is a legal document that must be created and signed off on by an attorney. Getting help with this document from anyone else may constitute practicing law without a license.
  3. Decide who will be the Trustee of the Qualified Income Trust. A trustee will have to be selected to handle the Qualified Income Trust. The trustee is the authorized signer on the account. Checks are imprinted with the same format as the account title. The trustee will receive the monthly statements. Only the trustee can write checks to get funds out of the QIT account. The trustee has a responsibility to manage the account correctly, keep detailed records, and be ready to report to the county Department of Family and Children Services (or even to the Department of Community Health). Currently trustees are required to make a reporting once every six months.
  4. Set up the Qualified Income Trust at a bank. The Qualified Income Trust will be connected to a checking account that ideally is non-interest bearing and carries no service charges. As a practical matter, however, it may be difficult to establish a trust account with a local bank that does not carry a service charge. Bank service charges are an allowable deduction from the individual’s personal needs allowance. The QIT bank account should be titled in such a way that it is identified as such, i.e. “The Qualified Income Trust.”
  5. Fund the Qualified Income Trust with income only. Qualified Income Trusts deal only with income. Once a nursing home resident is otherwise eligible for Medicaid, a QIT must be established and funded with the nursing home resident’s income. This trust has nothing to do with savings or any other assets.
  6. Use the Qualified Income Trust correctly every month that Medicaid is needed. Every month that Medicaid is needed, the nursing home resident’s income will be put into this account, and bills will then be paid from this account. Only authorized payments can be made from this account. The account must be zeroed out each month. Failure to comply with Medicaid’s rules for Qualified Income Trusts can cause the nursing home resident to lose his/her Medicaid benefits.


In order to qualify for Nursing Home Medicaid (and to maintain Medicaid eligibility) it is critical that the resident’s income be handled correctly every month. Being out of compliance with Medicaid regulations can be costly and terrifying. If you have questions about setting up a Qualified Income Trust for Nursing Home Medicaid in Georgia, please contact Hurley Elder Care Law for a complimentary phone consultation by calling (404) 843-0121.

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