Instead of establishing a Qualified Income Trust for the $250 over her $2000 liability, can I have an insurance policy written?

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Also Miller is not a DIY project, most of the time the dpoa has an elder law atty to do the trust.
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Did anyone explain to you how a QIT aka a Miller Trust has to be set up or done to be compliant for Medicaid for your state? Just how & what will be dependent on your states laws.

So your elders monthly income (which has been determined to be a guaranteed qualified income source) is $ 250.00 above the monthly income ceiling, right? If so then there seems to be 2 slightly different paths for dealing with a QIT for the excess income....1way is more simple all their income sent directly to the facility each month & the facility gets all funds; the other is more complicated where the income is paid to the trust with the required maximum SOC (share of cost) paid to the facility and the overage ($250) held in a master fund by the state with the state as the beneficiary of the trust upon their death. Whichever way the QIT is done to be automatically flexible & adjust for changes in income (like SS gets a COLA). The elder gets a small personal needs allowance each month ($35-105), held at the facility, but that's it for $ once an individual is on Medicaid.

Either way all income goes to the state.

A life insurance policy....well I doubt the elder who is requiring skilled nursing care in a NH could even get one written much less find a underwriter who would do it for what the state is going to require for compliance (like a specific or no commission) or that the state would even allow it. But you can & should ask the caseworker.

If your thinking a "insurance policy" would build by $ 250 each mo & provide for $$ for funeral, burial or for an inheritance, that's not going to happen. Once on Medicaid, all their monthly income is paid towards their care 1 way or another.
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