top of page
  • Writer's pictureTroyer & Good, PC

How to Set Up a Miller Trust

Updated: Aug 27, 2019

set up miller trust

Do you or does someone you love need a Miller Trust? Below are the basic steps to setting up the Miller Trust.


Identify someone to serve as Trustee and, if possible, someone to serve as a backup in case your first choice becomes unable to act for you. The Trustee’s job will be to make sure the right amount of your income goes into the Trust account and to then write checks to spend it on your medical bills and as otherwise allowed by Medicaid. The Trustee must keep detailed records showing how the money was spent. YOU CANNOT BE YOUR OWN TRUSTEE.


Identify someone to set up the trust. Ideally, the person whose income will go into the trust (i.e., the Medicaid recipient) is also the person who sets it up. In legal terms, this person is called a “Grantor” or “Settlor”.

However, if that person is not capable of understanding what he or she would be signing, then there are others who could set up the trust. Examples include someone named as the person’s power of attorney, a court-appointed guardian, an authorized representative for Medicaid, a representative payee for Social Security or other public benefits source, or someone with the ability to move the person’s income into the Trust account.


Name someone to receive what is left in the trust after Medicaid is paid back. It is highly unlikely that anything would be left in this trust when the trust ends. If there is something left, then it will most likely go to Medicaid. However, if there is more than enough to payback Medicaid, you can name beneficiaries (persons to receive trust funds after your death, such as your children or grandchildren) just in case.


Choose a place to set up your trust checking account. This checking account will only have money in it for part of the month. Money will be transferred or deposited into the trust checking account from your regular checking account, and then it will be paid out for medical expenses.

It will be difficult to pay bank fees because all of the income going into the trust will be needed to pay the nursing home or other medical bills. So, ideally, you will want a no-fee checking account with a very low minimum balance. Both your regular checking account and your trust checking account can be at the same bank or credit union.


Give our office current records showing your gross income from each source. Bank statements showing direct deposits cannot be relied on for this. Also, last year’s 1099s will not work. The kinds of things that will work include:

  • Social Security benefit letter for the current year

  • Pension benefit letter or paystub for current year or month

  • Annuity benefit letter

  • Current account statements showing interest income, if any

  • Farm cash rent agreement

  • CRP Agreement

  • Long Term Care Insurance EOB

  • Anything else that clearly shows the source of the income and the gross amount before any withholdings


Give us proof of the current amount of your health insurance premiums, like Medicare supplement policy, Medicare Advantage policy, Medicare Part D prescription drug policy, retiree health insurance, etc.


Give our office your latest Medicaid notice showing your current nursing home “liability”. This is the notice telling you how much you must pay to the nursing home each month. It will help us make sure we are setting up the trust correctly for you.

If you need a Miller Trust or are unsure if you do, speak with one of our attorneys. We can help analyze your situation to determine if a Miller Trust is needed. If it is needed, we can create one for you so that you remain eligible for Medicaid.


bottom of page