The Pros and Cons of a Miller Trust

miller trust

Firstly, what is a Miller Trust? 

Texas falls under the list of states that have an “income-cap” and makes an allowance for a Miller Trust. Should the applicant’s income be more than the “income-cap”, the applicant’s initial income needs to be adjusted downward. 

By redirecting income to the Miller trust, and lowering the initial income, this will allow for the applicant to qualify for the Medicaid program.

The Miller trust will then pay then Medicaid recipient a small monthly allowance. 

The Pros of a Miller Trust.

  • When an applicant’s income exceeds the “income-cap”($2,349 / month for a single applicant) as per Texas law, and still does not have enough income to pay for long term care, Miller Trusts allow individuals to receive Medicaid benefits for long term care services.
  • Miller Trusts can be used to pay for a small monthly allowance, Medicare premiums and medical expenses that are not covered by Medicaid.
  • Unlike other types of trusts, there are very few restrictions on who can establish a Miller Trust to qualify for government benefits.
  • Any applicant of any age who is otherwise eligible for the Medicaid program can establish a trust of this nature.


  • A Miller Trust can only be used to hold income going to the individual who is trying to qualify for Medicaid.
  • A Miller Trust cannot be used by the trustee for any other purpose than the Medicaid applicant’s allowable expenses.
  • The full amount of the applicant’s income is required to be deposited into the trust account; therefore portions of certain income sources are not allowed. You cannot put part of your pension or social security check into the trust – its either all or nothing.
  • On the death of the Medicaid applicant the state has priority to recover expenses that Medicaid paid on behalf of the beneficiary. Anything remaining in the Trust after the death of the Medicaid applicant must be reimbursed to pay those expenses incurred by the state. 
  • If a Miller Trust is not set up correctly, it can harm your application.  
  • A trustee is also required to be named to administer the trust 

It is vitally important to understand the rules surrounding a Miller Trust in the state where the applicant resides.

The services of an experienced Elder Law and Estate Planning lawyer to devise a trust is highly recommended. Not following the correct process can be costly and ruin your chances of qualifying for Medicaid. 

We at SCC Legal understand what is required and can assist in your Medicaid Planning.

Planning for your future can be daunting. That is why you can rest assured in placing your Medicaid Planning in the hands of Frank Campisano

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