Florida Miller Trust (Qualified Income Trust): The 2026 Guide to the $2,982 Income Cap

Florida’s 2026 Medicaid income cap is $2,982 per month for a single applicant. If your monthly income — Social Security, pension, annuities, and anything else — adds up to more than that, the Department of Children and Families will deny your application for long-term care Medicaid. You will be told you make too much to qualify for a program that pays for nursing home care, even when your actual income is a fraction of what that care costs.

A Miller Trust — known formally in Florida as a Qualified Income Trust (QIT) — is the legal tool that fixes this problem. It is a specific type of irrevocable trust authorized by federal statute. When it is drafted, funded, and administered correctly, the state treats the income that flows through it as unavailable for Medicaid-eligibility purposes, and the applicant qualifies.

This guide walks through the 2026 income cap, when you actually need a Miller Trust (and when you don’t), how the trust works month to month, what it cannot do, and the common mistakes that wreck an otherwise valid QIT.

The $2,982 Florida Medicaid Income Cap — 2026 Numbers

Florida is an income-cap state for long-term care Medicaid. That means there is a hard monthly income limit — not a range, not a sliding scale. You are either under it or you are not. The 2026 cap is $2,982 per month for a single applicant, and it is derived from 42 U.S.C. § 1396a(a)(10)(A)(ii)(V), which sets the threshold at 300% of the federal Supplemental Security Income (SSI) benefit rate.

Florida implements long-term care Medicaid under Fla. Stat. § 409.906, which authorizes the Agency for Health Care Administration and the Department of Children and Families to administer institutional-care and home-and-community-based services for qualifying applicants. The statutes list who is eligible and the programs the state funds — but nothing in § 409.906 gives the agency the power to waive the federal income cap. That is where the Miller Trust comes in.

For reference, a typical monthly Social Security benefit plus a modest pension will usually cross the $2,982 line. So will an annuity payout or a required minimum distribution from a retirement account. A surprising number of otherwise-modest retirees are “over-income” under Medicaid’s math even though their actual expenses leave them unable to pay for a nursing home privately. That gap is what the Miller Trust is designed to close.

Where “Miller Trust” Came From: Miller v. Ibarra

The Miller Trust gets its nickname from a 1990 federal decision in Colorado. In Miller v. Ibarra, 746 F. Supp. 19 (D. Colo. 1990), a class of applicants challenged Colorado’s refusal to let them qualify for Medicaid by routing excess income through an irrevocable trust. The district court agreed with the applicants and ordered the state to “treat the trust assets as ‘available’ to the plaintiffs, pursuant to 42 U.S.C. § 1396a(a)(17), only to the extent authorized by the terms of the trusts.” Miller, 746 F. Supp. at 30.

In plain English: income placed in a properly drafted irrevocable trust, over which the beneficiary has no practical control, is not countable income for Medicaid. Congress later codified the Miller result in what is now 42 U.S.C. § 1396p(d)(4)(B), which creates an express safe-harbor exception — sometimes called a “(d)(4)(B) trust” — for income trusts composed only of the applicant’s pension, Social Security, and other monthly income, with the state named as remainder beneficiary.

Every compliant Florida QIT lives inside that statutory safe harbor. A trust that deviates from the § 1396p(d)(4)(B) structure — even in small ways — is not a Miller Trust. It is a disqualifying transfer.

Do You Actually Need a Miller Trust?

Not every Medicaid applicant needs a QIT. The rule is simple:

• Monthly gross income under $2,982 (2026) — No QIT needed. You can apply for long-term care Medicaid directly, subject to the separate asset test and the 5-year look-back.
• Monthly gross income over $2,982 — You almost certainly need a QIT. Without one, the agency will deny the application the moment it runs the numbers, no matter how little in countable assets you hold.
• Married couple with one spouse applying — The rules get more nuanced. The non-applicant (the “community spouse”) has separate protections, and some portion of the institutionalized spouse’s income can be diverted to the community spouse before the cap calculation runs. We cover the spouse scenario further down.

One critical point that surprises most families: the QIT test looks at gross income, not net. Social Security, pension, annuities, and required retirement distributions are all counted before any withholding. Medicare Part B premiums do not reduce the figure that matters for the cap. Neither does income tax withholding. If the gross number is over $2,982, you are over the cap.

How a Florida QIT Works, Month to Month

A Miller Trust is simpler to operate than it sounds, but the mechanics are non-negotiable. Florida DCF and the Agency for Health Care Administration look at the trust account monthly, and sloppy administration is one of the fastest ways to lose eligibility.

1. Draft the trust document. Must be irrevocable. Must be composed only of the applicant’s own income (not assets). Must name the State of Florida Agency for Health Care Administration as the remainder beneficiary to the extent of Medicaid benefits paid. Must satisfy 42 U.S.C. § 1396p(d)(4)(B).
2. Open a dedicated trust bank account in the name of the trust, using the trust’s EIN (not the applicant’s Social Security number). No other money goes in. No comingling.
3. Direct-deposit the applicant’s income into the trust account. Social Security and most pensions can be redirected with standard payee-change forms. Income that arrives outside the trust account in a given month will generally be treated as countable income for that month.
4. Pay the applicant’s expenses from the trust account each month in the order dictated by Medicaid rules: (a) the applicant’s Personal Needs Allowance, (b) the community spouse’s Minimum Monthly Maintenance Needs Allowance if applicable, (c) health-insurance premiums, (d) the balance as the patient-responsibility payment to the nursing facility or care provider.
5. Zero out the account each month, or as close to zero as the math allows. Balances that accrue inside the trust create problems with the asset test.
6. Keep records. Statements, deposit receipts, and distribution ledgers. DCF can ask to see them at annual redetermination, and omissions here are how otherwise-valid trusts get unwound.

When administered correctly, the income that passes through the QIT is not counted against the $2,982 cap. The applicant qualifies. Medicaid pays the bulk of nursing-home costs. The family keeps whatever exempt assets they were entitled to keep under the separate asset rules.

What a Miller Trust Cannot Do

A QIT solves one problem: excess income. It does not solve several others that families often assume it does.

• It does not shelter assets. The asset test is a separate rule with a separate limit — $2,000 for a single applicant in 2026. A QIT has nothing to do with a bank account, a second home, or a brokerage portfolio. If you need asset protection, you need a different tool, typically a Medicaid Asset Protection Trust or one of the other strategies that work with Florida’s rules.
• It does not defeat the 5-year look-back. The look-back scrutinizes transfers of resources, not recurring monthly income. But if you move assets into a QIT — even accidentally — the transfer counts against the look-back and triggers a penalty period.
• It does not protect the homestead. Florida homestead law, estate recovery, and tools like a Lady Bird Deed handle the house. A QIT has no role there.
• It does not help retroactively. A QIT can only cover income that runs through it after the trust is funded and operating. You cannot file a QIT for September and claim it retroactively protected June’s income.

A QIT is a surgical tool. It does one thing well. Medicaid planning that relies on a QIT alone to solve a crisis usually fails; real plans pair the trust with asset strategies, spousal allocations, and sometimes annuity conversions depending on the facts.

If You Are Married: Community Spouse Rules

When one spouse is entering long-term care and the other is staying in the community, the math changes in ways that can reduce or eliminate the need for a QIT. Federal law — 42 U.S.C. § 1396r-5, implemented in Florida under Fla. Admin. Code r. 65A-1.712 — allows a portion of the institutionalized spouse’s income to be diverted to the community spouse through the Minimum Monthly Maintenance Needs Allowance (MMMNA) before the income-cap analysis runs on the applicant.

The Fourth District Court of Appeal made clear in Gorlick v. Florida Department of Children and Families, 789 So. 2d 1247 (Fla. 4th DCA 2001), that the community spouse acting as power-of-attorney for the institutionalized spouse is a valid representative for purposes of signing the assignment of support form, even though the community spouse has “a vested interest in the outcome” of the application. Gorlick, 789 So. 2d at 1248. DCF cannot refuse to accept a spouse’s signature as representative simply because the outcome benefits the family. That holding matters because many denials still turn on this exact issue at the hearing-officer level, and the Fourth DCA’s rule controls.

The practical takeaway for a couple: before your attorney drafts a QIT, the community-spouse diversion should be calculated. If income can be shifted to the community spouse lawfully and the institutionalized spouse’s remaining income falls below the $2,982 cap, no QIT is needed. This is a case-by-case analysis and the figures change each January when the federal limits update.

Cost and Timing

Most Florida elder-law attorneys charge a flat fee for QIT drafting and setup, typically in the range of $1,200 to $2,500 depending on the complexity of the broader plan. That usually includes the trust document, EIN application, trust-account setup coordination with the bank, and direction on the income redirection to the trust account.

Timing matters. The trust must be drafted, funded, and operating before the month you want Medicaid eligibility to begin. DCF looks at the trust’s operation month by month; a trust that exists on paper but has no deposits and distributions in the relevant month will not qualify. In a true crisis — a family member already in a facility with a fast-approaching private-pay exhaustion date — a QIT can be stood up quickly, often within a week or two, but it cannot be backdated.

Common Mistakes That Disqualify a QIT

• Drafting the trust as revocable. A revocable trust does not satisfy § 1396p(d)(4)(B). It is not a Miller Trust — it is a disqualifying transfer that triggers a look-back penalty.
• Funding with assets instead of income. Dropping a savings account balance into the QIT is one of the worst mistakes. Only the applicant’s monthly income goes in. Principal transfers are penalized.
• Missing the state-remainder clause. The trust must name Florida’s Agency for Health Care Administration as the remainder beneficiary to the extent of Medicaid benefits paid. Omitting this clause breaks safe-harbor qualification.
• Comingling. Depositing non-QIT funds into the trust account, or paying non-QIT expenses out of it, voids the clean-account treatment that makes the trust work.
• Letting the account accumulate. Balances that build up inside the trust are treated as countable resources. Zero out the account each month to the extent the math permits.
• DIY templates. Generic online QIT forms frequently omit required Florida-specific provisions, list the wrong state agency, or misidentify the eligible-income types. The $500 you save drafting it yourself is rarely worth the $80,000-per-year private-pay nursing-home bill you run up waiting for the re-draft.

Frequently Asked Questions

Does a QIT protect my house?

No. A QIT is only about income. The house is governed by Florida’s homestead rules, Medicaid estate recovery under Fla. Stat. § 409.9101, and tools like a Lady Bird Deed. See our guide on whether Medicaid can take your Florida house.

Can I fund a QIT with my spouse’s income?

No. Only the Medicaid applicant’s own income goes into the applicant’s QIT. The community spouse’s income is analyzed separately under the MMMNA rules. Putting a spouse’s income into the applicant’s QIT is one of the faster ways to invalidate the trust.

What happens to the money left in the QIT when the applicant dies?

Under the state-remainder clause, the residual balance is paid to the Florida Agency for Health Care Administration up to the total amount of Medicaid benefits the agency paid for the beneficiary’s care. Only funds above that amount, if any, pass to the applicant’s estate or named remainder beneficiaries. In practice, a well-administered QIT is zeroed out monthly, so there is rarely a significant balance remaining.

Do I need a new QIT every year?

No. One properly drafted QIT governs all income going forward. You will, however, need to recalculate the income numbers every January when the federal cap, the SSI benefit rate, and the MMMNA figures update.

Is a Miller Trust the same as a Special Needs Trust?

No. A Special Needs Trust (sometimes called a Supplemental Needs Trust, or a “(d)(4)(A) trust”) protects assets — typically a personal-injury settlement or inheritance — for a disabled individual without disqualifying them from needs-based benefits. A Miller Trust — a “(d)(4)(B) trust” — is narrower: income-only, for long-term care Medicaid eligibility. The two tools solve different problems and are drafted differently.

How Zoecklein Law Helps With Florida Miller Trusts

We draft Miller Trusts as part of a full long-term care Medicaid plan — not as a one-off document. That means we look at the whole picture before we draft: gross income, asset composition, community-spouse allocation, homestead strategy, look-back exposure, and timing against the facility’s private-pay runway. A QIT built without those inputs can still be valid on paper but fail the family in practice.

Our elder-law practice covers Hillsborough, Pinellas, Polk, Pasco, Manatee, Sarasota, and Orange Counties, with offices in Brandon, St. Petersburg, and Orlando. If a family member’s income is putting nursing-home Medicaid out of reach, we can usually tell you in the first 15-minute consultation whether a Miller Trust will solve the problem, whether you also need asset-side planning, and whether the community-spouse math changes the picture.

To schedule a consultation, call (877) 206-0022 or request an appointment online.

This article is general legal information and is not legal advice for any specific matter. Florida Medicaid rules change each January and occasionally mid-year by state-plan amendment. Confirm current figures and apply the law to your specific facts with a Florida-licensed elder-law attorney before relying on anything here.

Authorities cited:

• Miller v. Ibarra, 746 F. Supp. 19 (D. Colo. 1990)
• Gorlick v. Florida Dept. of Children & Families, 789 So. 2d 1247 (Fla. 4th DCA 2001)
• 42 U.S.C. § 1396p(d)(4)(B)
• 42 U.S.C. § 1396a(a)(10)(A)(ii)(V)
• 42 U.S.C. § 1396r-5 (spousal impoverishment provisions)
• Fla. Stat. § 409.906 (Medicaid eligibility)
• Fla. Stat. § 409.9101 (Medicaid estate recovery)
• Fla. Admin. Code r. 65A-1.712 (SSI-Related Medicaid Resource Eligibility)