What is a Qualified Income Trust (QIT) in Texas?

If your income is slightly too high to qualify for Texas Medicaid long-term care benefits, a Qualified Income Trust (QIT) — also known as a Miller Trust — can make all the difference.

A QIT is a special, Medicaid-approved trust that allows individuals whose income exceeds the state limit (currently $2,901 per month in 2025) to still qualify for nursing home Medicaid care.

Here’s how it works: your “excess” income is deposited into the trust each month, and because it’s held there, it no longer counts against you when Medicaid reviews your eligibility. A trustee (often a family member or trusted friend) manages the trust and pays certain approved expenses from it under Medicaid’s strict guidelines.

When the Medicaid recipient passes away, any remaining funds in the trust are used to reimburse the State of Texas for Medicaid benefits paid — ensuring compliance with Medicaid’s recovery rules.

How a QIT Can Help You

A QIT can be a powerful planning tool for Texans who need care but don’t want to lose everything to nursing home costs. Here are the main benefits:

Benefit	How It Helps
Medicaid Eligibility	Allows you to qualify for Medicaid long-term care coverage even if your income is over the limit.
Lower Nursing Home Costs	Medicaid pays nursing home at much lower contracted rates — saving you thousands of dollars each month.
Keep a Personal Allowance	You may keep a Personal Needs Allowance (up to $75 per month in 2025) for personal expenses, and your spouse may be entitled to a portion of the income for living costs.
Protect Your Spouse	QITs help support the community spouse by allowing part of your income to go to them, preventing financial hardship.
Avoid Medicaid Penalties	When properly drafted and managed, a QIT prevents disqualification due to excess income or improper transfers.
Use Funds for Approved Expenses	The trustee can use trust funds for medical expenses, insurance premiums, or trust administration fees without affecting eligibility.

Important to Know

A QIT does not shelter income from taxes or creditors, and it ends when the Medicaid recipient passes away. Because Medicaid’s rules are very specific, even small mistakes can lead to a denial of benefits.

That’s why it’s critical to have a QIT drafted by an experienced Texas elder law attorney like Eric Golle Medicaid lawyer and certified public accountant who understands the state’s Medicaid rules and can ensure the trust is set up correctly from the start.

We Can Help

Golle Law helps families across Texas set up Qualified Income Trusts and navigate the Medicaid eligibility process with confidence. We’ll guide you step-by-step — from drafting and signing the trust, to funding it each month, to maintaining compliance so benefits stay secure.

If you or a loved needs long-term care, don’t wait until a crisis. Contact Golle Law today to learn how a QIT can help protect your income and preserve your eligibility for essential care.