I have read that it protects any money that your loved one has when applying for Medicaid. I have so much more to learn about it, but if you have any information please share. Thanks
Miller is designed to ENABLE an individual with too high monthly income to BECOME eligible for LTC Medicaid. LTC Medicaid has very rigid rules on income and asset maximums…. tends to be $2200 mo income & 2K nonexempt assets for most states for an individual.
Miller is imo NOT designed to protect assets at all. Miller is NOT available in all states. States that don’t do Miller tend to have another way (some sort of QIT like what Lea posted) to deal with the too much income problem. How a Miller runs in a state that allows them is very interdependent on state laws as to beneficiary aspect. Miller can be used ONLY on income that is “guaranteed”.
Let’s say MeeMaw is 92 & very much needs skilled nursing care in a NH. She’s in NH post hospitalization & has plateaued in rehab and cannot go back to her apt to live on her own. MeeMaw has only $1800 in savings - so she’s totally good on her asset limit as she’s under 2K max - BUT she gets $1200 in SS$ plus $900 annuity + $200pension, so $2300 income each month. $2300. MeeMaw is $100 OVER $2200 maximum allowed, so MeeMaw cannot be financially “at need” for LTC Medicaid. Ineligible for a mere $100 extra in income!!!
& this good people is what & why a Miller Trust is mucho importante!
A Miller can via a Trust document become owner of a guaranteed income. SSA income is a guaranteed income resource so it goes to create Miller. She’s no longer owner of SSA $, she now just has $900 annuity + $200 pension. So Voila! MeeMaw’s at $1100 mo. income so under her states $2200 monthly income max. The reason why annuity and pension not included in Miller is they may not be truly “guaranteed”, so these stay as they were…. still in her name and she will have them used in her required by LTC Medicaid copay to the NH ea month.
Her old SSA now goes into Miller ea month. Just what happens to $ depends on your state laws. Some have all $ go as copay to NH so it’s a zero sum game; but others have Miller $ pay NH the amount needed only to mo income max allowed by your state Medicaid. So in MeeMaws case, Miller bank account would retain $100 extra ea mo and it would build by $100 ea mo (or more should her SSA increase due to a COLA) till her death; then upon death would be paid to Trust beneficiary. The beneficiary of the Trust will be State Medicaid program as primary beneficiary and then heirs as secondary. BUT Keep in mind that every day MeeMaw is creating a room&board NH tally which the State is going to have to attempt a recoup from the elders after death assets, via estate recovery system. $ left in the Miller gets paid to the state first and foremost and only should there be any $ left over will it go to the secondary beneficiary.
Should elder be married (there’s a Community Spouse) & should CS need some of NH spouses mo income to pay household expenses, CS would seek to get some of NH spouses income waived to them. It’s done via CSResourceAllowance or MoMaintenanceNeedsAssessment and not a Miller Trust. CSRA & MMNA divert or waiver some NH spouse mo income to CS rather than be almost all towards their NH copay. NH/CS situation is beyond way way more complex and imo not ever a DIY. It’s CELA level of atty work to get the best & legit $/asset moves done ahead of the NH spouse ever applying for LTC Medicaid. CS needs experienced atty guidance. Please pls don’t try to DIY.
If the Social Security income of recipient is in Miller Trust at time of death, and the state uses it for estate recovery, does this prevent surviving community spouse from collecting the deceased's social security after death of NH spouse? (Provided the deceased SS was more than the widow/widower)
The purpose of a Miller Trust which is only available in SOME states is as follows:
What Is a Miller Trust? In order to qualify for Medicaid, the applicant's income must fall below a certain level. Most states allow individuals to spend down any income above this level on their care until they reach the state's income standard. But in some states (called "income cap" states), Medicaid applicants who have excess income can qualify for Medicaid only if they put the excess in a special trust, called a "Miller" trust or a "Qualified Income Trust."
The Miller trust can pay the Medicaid recipient a small personal needs allowance, and the trust can also be used to pay the recipient's spouse a monthly allowance. Any additional money is used to pay the recipient's share of his or her cost of care. If there is any money left in the trust when the recipient dies, Medicaid has a right to the money to recover the cost of care.
If an elder earns TOO MUCH INCOME to qualify for Medicaid, the extra can be put into a Miller Trust to be used for monthly needs so they can still qualify for Medicaid long term care.
THAT is the purpose of a Miller Trust; not to 'protect money your loved one has when applying for Medicaid.' To try and protect assets from Medicaid is to hide money from the government and get DISQUALIFIED from getting benefits. The purpose of having assets is for them to be USED for the elder's care in their old age; not to be hidden away and passed on to her children as an inheritance.
God I have read so much about this too...mostly for sport...
Miller Trusts vary a lot by state depending on Medicaid income caps...they are great for protecting income for the non-medicaid applying spouse----there is also a cap on the monthly draw for the spouse---but, it also keeps medicaid out of the spouse's business for as long as possible.
They seem kind of crappy in one sense if you aren't going to be able to exhaust the funds before death, since the state is entitled to any remaining money in them...it doesn't protect the money for the spouse in the event the medicaid receiver dies, and will not protect an inheritance.
Miller is imo NOT designed to protect assets at all.
Miller is NOT available in all states. States that don’t do Miller tend to have another way (some sort of QIT like what Lea posted) to deal with the too much income problem.
How a Miller runs in a state that allows them is very interdependent on state laws as to beneficiary aspect.
Miller can be used ONLY on income that is “guaranteed”.
Let’s say MeeMaw is 92 & very much needs skilled nursing care in a NH. She’s in NH post hospitalization & has plateaued in rehab and cannot go back to her apt to live on her own. MeeMaw has only $1800 in savings - so she’s totally good on her asset limit as she’s under 2K max - BUT she gets $1200 in SS$ plus $900 annuity + $200pension, so $2300 income each month. $2300. MeeMaw is $100 OVER $2200 maximum allowed, so MeeMaw cannot be financially “at need” for LTC Medicaid. Ineligible for a mere $100 extra in income!!!
& this good people is what & why a Miller Trust is mucho importante!
A Miller can via a Trust document become owner of a guaranteed income. SSA income is a guaranteed income resource so it goes to create Miller. She’s no longer owner of SSA $, she now just has $900 annuity + $200 pension. So Voila! MeeMaw’s at $1100 mo. income so under her states $2200 monthly income max. The reason why annuity and pension not included in Miller is they may not be truly “guaranteed”, so these stay as they were…. still in her name and she will have them used in her required by LTC Medicaid copay to the NH ea month.
Her old SSA now goes into Miller ea month. Just what happens to $ depends on your state laws. Some have all $ go as copay to NH so it’s a zero sum game; but others have Miller $ pay NH the amount needed only to mo income max allowed by your state Medicaid. So in MeeMaws case, Miller bank account would retain $100 extra ea mo and it would build by $100 ea mo (or more should her SSA increase due to a COLA) till her death; then upon death would be paid to Trust beneficiary. The beneficiary of the Trust will be State Medicaid program as primary beneficiary and then heirs as secondary.
BUT
Keep in mind that every day MeeMaw is creating a room&board NH tally which the State is going to have to attempt a recoup from the elders after death assets, via estate recovery system. $ left in the Miller gets paid to the state first and foremost and only should there be any $ left over will it go to the secondary beneficiary.
Should elder be married (there’s a Community Spouse) & should CS need some of NH spouses mo income to pay household expenses, CS would seek to get some of NH spouses income waived to them. It’s done via CSResourceAllowance or MoMaintenanceNeedsAssessment and not a Miller Trust. CSRA & MMNA divert or waiver some NH spouse mo income to CS rather than be almost all towards their NH copay. NH/CS situation is beyond way way more complex and imo not ever a DIY. It’s CELA level of atty work to get the best & legit $/asset moves done ahead of the NH spouse ever applying for LTC Medicaid. CS needs experienced atty guidance. Please pls don’t try to DIY.
What Is a Miller Trust?
In order to qualify for Medicaid, the applicant's income must fall below a certain level. Most states allow individuals to spend down any income above this level on their care until they reach the state's income standard. But in some states (called "income cap" states), Medicaid applicants who have excess income can qualify for Medicaid only if they put the excess in a special trust, called a "Miller" trust or a "Qualified Income Trust."
The Miller trust can pay the Medicaid recipient a small personal needs allowance, and the trust can also be used to pay the recipient's spouse a monthly allowance. Any additional money is used to pay the recipient's share of his or her cost of care. If there is any money left in the trust when the recipient dies, Medicaid has a right to the money to recover the cost of care.
If an elder earns TOO MUCH INCOME to qualify for Medicaid, the extra can be put into a Miller Trust to be used for monthly needs so they can still qualify for Medicaid long term care.
THAT is the purpose of a Miller Trust; not to 'protect money your loved one has when applying for Medicaid.' To try and protect assets from Medicaid is to hide money from the government and get DISQUALIFIED from getting benefits. The purpose of having assets is for them to be USED for the elder's care in their old age; not to be hidden away and passed on to her children as an inheritance.
Miller Trusts vary a lot by state depending on Medicaid income caps...they are great for protecting income for the non-medicaid applying spouse----there is also a cap on the monthly draw for the spouse---but, it also keeps medicaid out of the spouse's business for as long as possible.
They seem kind of crappy in one sense if you aren't going to be able to exhaust the funds before death, since the state is entitled to any remaining money in them...it doesn't protect the money for the spouse in the event the medicaid receiver dies, and will not protect an inheritance.