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View Diary: So how depressed are you?/Update x 2 (156 comments)

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  •  Have you considered a Miller Trust? (16+ / 0-)

    Qualified Income Trust ("Miller" Trust)

    We set one up for my Mother-in-law as she was $73 a month too rich for Medicaid. They're tricky, so you definitely need an attorney, and you will have to fight the bureaucracy of your state Medicaid. But definitely worth doing. They took care of pretty much everything medical so we could care for her at home. Nursing assistance, home medical equipment, even a doctor.

    Please look into this, for your sanity if nothing else.

    How quickly the Pacifist becomes the Warrior when it's "our side" doing the killing.

    by edg on Mon Aug 15, 2011 at 07:05:48 PM PDT

    •  This is new news to me and I find it (0+ / 0-)

      very interesting.  Here's the Wikipedia entry for Miller Trusts, for those who, like me, didn't know of their existence:

      A "Miller" Trust can be used to qualify a Medicaid applicant with income in excess of the eligibility limit (not imposed in all states) for long-term care assistance from Medicaid. Such a trust is not really a "special needs" trust at all; it is not funded with the beneficiary's assets. The Miller trust can be named as recipient of the individual's income, from a pension plan, Social Security, or other source. The Miller trust takes its name from the Colorado case of Miller v. Ibarra, 746 F. Supp. 19 (D. Colo. 1990), and is specifically sanctioned by 42 U.S.C. § 1396p(d)(4)(B). As with a self-settled special needs trust (referred to above as a "Disabled Individual’s Trust"), upon the death of the beneficiary, the State Medicaid agency must be paid back for its medical assistance from any remaining assets in the Miller trust. An older name for the Miller trust, still occasionally used, is “Utah Gap" trusts, reportedly coined by a Colorado advocate describing the gap between the income cap for eligibility and the actual cost of nursing home care as similar to the yawning chasm between mesas dotting the Southern Utah landscape. The Miller trust is significant only in those states which impose an income cap on Medicaid long-term care eligibility; ironically, Utah is not one of those states. Income caps are in place in about half of the states. Also referred to as a qualified income trust.

      One would think that there might be lawyers around who would do this for a pretty reasonable fee.  After all, the problem is that their client is on the very edge of poverty. But it might also be possible to create the trust without a lawyer, I don't know.  Forms are available state-by-state for $25 at  They may be available elsewhere for less -- or even free.  

      If we don't fight hard enough for the things we stand for, at some point we have to recognize that we don't really stand for them. Paul Wellstone

      by Alice Olson on Tue Aug 16, 2011 at 09:20:39 AM PDT

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      •  I think it cost us about $350. (0+ / 0-)

        That included one revision to the documents and the lawyer's participation on two conference calls with the Arizona Medicaid system legal staff. The local administrative staff knew nothing about Miller Trusts and it was a major battle getting it approved. It took 6 months. I'm fairly handy with legal matters but this one was above my pay grade.

        After it was in place, my wife was able to get paid for providing caregiving. That helped replace some of the income she lost after quitting her jor to care for her mother, and it set us up to take advantage of respite care so we could get and occasional break.

        How quickly the Pacifist becomes the Warrior when it's "our side" doing the killing.

        by edg on Sat Aug 20, 2011 at 03:12:02 AM PDT

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