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I need to set up Miller Trust for my 93 year old Mother. Her total gross monthly income is $1,337.00 and only asset remaining is $900.00 cremation policy, less and $1,000.00 in checking. I am trying to get her approved for Assisted Living Facility through Texas Star & Plus Medicaid Waiver and need to reduce her monthly income (social security plus $157.00 pension). She has Medicare coverage. We are residents of Nueces County, Texas.

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Lizzywho - your moms county retirement wasn't viewed as "qualified" for the Miller. So it couldn't be included like her SS. The income sources have to ensured in some way to be from a guaranteed continuous source. which not all pensions or retirements are....

Andy - I'm echoing what others have said. Last I looked TX LTC Medicaid had income max at about $ 2,100 & assets at 2k. If your moms income is about $ 1,500 a mo, she is under income limits so no miller needed. I'd suggest you clearly find out what Medicaid is viewing your moms income to be and if under income ceiling. Also find out if the AL you are looking at has an immediate Medicaid open bed & will hold for her. Waivers are not dedicated funding for medicaid like NH are. Mom may need to private pay till a Medicaid bed is available at the AL. If that is the situation, are you prepared to pay for whatever overage cost is after she pays from her income?

If for some reason, mom needs a Miller, it needs to be done by an atty. Miller kinda has to be done by an atty so that's it's flexible for any changes to state laws & compliant for Medicaid. For atty's, there's going to be several in Corpus. The Area on Aging with the Coastal Bend Council of Governments should have a list. Google cbcog98.org. COGs are your tax $$$s at work, use them!
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You need to get a lawyer to help you set up the Miller Trust so that it is fully compliant in the State of Texas. You can contact Legal Aid in your county and see if they have pro-bono lawyers, or you can use a portion of the money setting up the Miller Trust as spend-down. I recommend lawyer because there have been recent changes in the laws and you want to make sure you are fully Medicaid compliant...yes, we are having to look at this for my in-laws if they ever cooperate:(
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I don't understand why you need a Miller trust if her income is already below the amount that qualifies her for Medicaid. How low does it need to be for this specific program?
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Yes you will need an Attorney to draw up the legal document for the Miller Trust. With document in hand I was sent to a Bank that opens these types of checking accounts. Not all Banks, Credit Unions will open these types of Checking Accounts. At least not here in Texas. :) I was in the process of spending down her funds on private care and was allowed to use Mom's funds for the the Attorney's fee. Mom's income was $200 a month more than Medicaid allowed. The Miller Trust allowed for her funds to pass thru "the checking account" on the way to the nursing home. First thru her personal checking account where they were direct deposited. Pay allowed expenses, hold back $60 that Medicaid allowed her to keep. Then transfer the remaining monthly income to "the checking account" . THEN write a check to the nursing home. You will need to verify what can be left in "the checking account". It's a minimal amount. That was the sticking point with my Mom and Medicaid. The woman that was advising me wasn't clear on the minimal amount or the proper deposit/transfer procedure, timeline, etc, and the whole process took a couple months longer than it should have. Not a pleasant place to find yourself after all Mom's funds are spent down! It's a tedious process and I am sure things have changed since I went thru this process in 2012. Oh! One thing that made my situation more weird...Mom was a County Retiree. Her retirement check could NOT be direct deposited to "the checking account"(Miller Trust). Good Luck!
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