Qualified Income Trusts in Georgia

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If you or a loved one needs nursing home care in Georgia, one of the biggest concerns is how to pay for it. Long-term care is expensive, and many people find themselves earning just a bit too much to qualify for Medicaid. That is where a Qualified Income Trust, or QIT, can make all the difference. At Slowik Estate Planning in Atlanta, Georgia, we help families understand how these trusts work and how to set one up properly so they can access the care they need.

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What Is a Qualified Income Trust?

A Qualified Income Trust, often called a QIT or Miller Trust, is a special legal tool that helps people qualify for Medicaid long-term care benefits when their income is too high. Georgia is what is known as an “income cap” state for Medicaid purposes. That means if your monthly income goes over a certain limit, you simply do not qualify, no matter how much you need the care. A QIT solves that problem by allowing you to redirect your excess income into a trust account each month, so that income no longer counts against you for Medicaid eligibility purposes.

Miller Trusts, also called Qualified Income Trusts, provide a way for Nursing Home Medicaid and Medicaid Waiver applicants who have income over Medicaid’s limit to become income-eligible. Income over Medicaid’s limit is put into a trust and is no longer counted as income, allowing the applicant to become eligible.

Think of it this way. Say your father receives Social Security and a pension totaling $3,200 per month. The 2026 income limit for Georgia Nursing Home Medicaid for a single applicant is $2,982 per month. Without a QIT, your father would be over the limit and ineligible for Medicaid coverage of his nursing home costs. With a properly drafted QIT, the excess income is deposited into the trust each month, bringing him under the income cap and making him eligible for benefits.

The QIT is rooted in federal law, specifically under the Omnibus Budget Reconciliation Act of 1993, which authorized the use of these trusts for Medicaid eligibility purposes. Georgia’s own Medicaid rules, administered through the Department of Community Health (DCH) and the Division of Family and Children Services (DFCS), govern exactly how a QIT must be structured and operated in our state. Under the Revised Georgia Trust Code of 2010 (O.C.G.A. Title 53, Chapter 12), trusts created in Georgia must meet specific legal requirements to be valid and enforceable. Getting this right from the start matters enormously. Contact Slowik Estate Planning to speak with an estate planning attorney in Atlanta who can walk you through the process.

Who Needs a Qualified Income Trust in Georgia?

Not everyone applying for Medicaid needs a QIT. You only need one if your gross monthly income exceeds Georgia’s Medicaid income cap. So who exactly might be in that situation? Many retirees who receive a combination of Social Security benefits, pension payments, and other retirement income can find themselves just over the limit. Veterans receiving VA benefits combined with Social Security may also exceed the threshold. Even a modest pension on top of Social Security can push someone over the line.

Qualified Income Trusts can only be used by Nursing Home Medicaid and HCBS Waivers applicants and beneficiaries. They cannot be used by ABD Medicaid applicants or beneficiaries. So if your loved one needs help at home through a Medicaid waiver program or requires full-time nursing home care, a QIT may be the right tool to help them qualify.

As of December 2025, there are 25 states that let Medicaid Long Term Care applicants and beneficiaries reduce their income to meet their income limit by using a QIT, and Georgia is one of them. This is good news for Georgia families. It means there is a legal path to Medicaid eligibility even when income is over the cap.

It is also worth knowing that the income limit applies to the applicant’s income only in most situations. The 2026 income limit is $2,982 per month for the applicant, and the income of the non-applicant spouse is not counted. So if your spouse is the one applying for nursing home Medicaid, your income as the community spouse does not affect their eligibility. Still, if the applying spouse’s income alone exceeds $2,982 per month, a QIT will be necessary. An Atlanta estate planning lawyer at Slowik Estate Planning can review your specific income picture and tell you exactly what you need.

How a Qualified Income Trust Works in Georgia

Setting up a QIT involves several important steps, and each one must be done correctly. The process starts with drafting a proper trust document. That document must meet very specific requirements under Georgia Medicaid rules before it will be accepted by DFCS.

The trust must be established for the benefit of the applicant and must be composed only of the applicant’s income, such as pension, Social Security, or VA benefits. It must also be irrevocable, because a revocable QIT does not meet the criteria and will be treated as a resource. This is a critical point. If the trust can be revoked or changed, it will not work for Medicaid purposes.

Once the trust document is signed, the trustee opens a dedicated checking account in the name of the trust. Each month, the Medicaid recipient’s income that exceeds the cap is transferred into that account. The income cannot be placed into the QIT by direct deposit from the source of income, such as Social Security. However, the current month’s income may be transferred from another bank account to the QIT account.

Handled properly, the Qualified Income Trust will always have a zero dollar balance at the end of each month. The only exception is if the bank requires a minimum balance to hold the account open. The trustee must manage disbursements carefully every single month. The QIT may not be backdated. It is effective beginning the month in which it is completed and signed by all required parties, not before. Timing matters. If a QIT is needed, it should be set up as quickly as possible.

Under O.C.G.A. § 53-12-200 through § 53-12-221, trustees in Georgia have specific duties and responsibilities. The trustee of a QIT must handle the account properly every month, or Medicaid benefits could be at risk. If the trustee fails to properly handle the Qualified Income Trust, this may result in the termination of Medicaid benefits for the resident, as well as an obligation to repay the program for payments made on the resident’s behalf during months that the trust was improperly managed. Proper trust administration is not optional. It is essential.

What Happens to the Money in a Qualified Income Trust?

One of the most common questions people have about QITs is what actually happens to the money deposited each month. The answer is that the funds can only be used for very specific purposes. You cannot use QIT money freely, and you cannot save it up for family members.

The only income removed from the QIT should be for payment of the patient liability to the facility, the Personal Needs Allowance, diversion to the community spouse or dependent children, medical expenses of the community spouse, or other medical expenses of the applicant not covered by Medicaid.

The Personal Needs Allowance (PNA) is a small amount the Medicaid recipient is allowed to keep for personal expenses. Georgia Nursing Home Medicaid beneficiaries are only allowed to keep $70 per month of their income as a personal needs allowance, plus enough to make Medicare premium payments if they are dual eligible.

If the Medicaid recipient is married, some funds may also be diverted to the community spouse to prevent financial hardship. If a Medicaid recipient’s spouse who is not covered by Medicaid and living in the community does not have enough money to live comfortably, a certain amount can be withdrawn from the QIT every month and paid to the spouse. The maximum allowable Monthly Maintenance Needs Allowance in 2026 is $4,066.50 per month.

What happens when the Medicaid recipient passes away? Upon the Medicaid recipient’s death, the state is named as the beneficiary of the QIT. If there are any funds remaining in the trust account, the state will receive it as reimbursement for funds paid for the care of the Medicaid recipient. This is sometimes called Medicaid estate recovery. It is important for families to understand this upfront. A QIT does not preserve money for heirs. Its purpose is to help a loved one access the care they need. For questions about protecting assets for your family, Slowik Estate Planning can discuss other planning strategies with you as trust beneficiaries may have options worth exploring.

How Slowik Estate Planning Can Help You Set Up a QIT in Atlanta

Setting up a Qualified Income Trust in Georgia is not something you want to do on your own. The rules are strict, the timing is critical, and a mistake can cost your family thousands of dollars in lost Medicaid benefits. At Slowik Estate Planning, located in Atlanta, Georgia, we work with families throughout the Atlanta area to draft QITs that meet Georgia Medicaid requirements and help loved ones access the care they need.

The trust document itself must be carefully drafted. An applicant must establish a QIT in Georgia. A QIT established in another state cannot be used to qualify for Georgia Medicaid. This means you need an attorney who is familiar with Georgia’s specific requirements, not just general Medicaid law.

Who can sign the QIT and serve as trustee? The Medicaid applicant or recipient can sign the trust, but they may not serve as trustee. The applicant’s court-appointed guardian or conservator can sign the trust and serve as trustee. The attorney-in-fact, or Power of Attorney agent, can also sign the trust and serve as trustee. Having a valid, up-to-date Power of Attorney is often essential in these situations. If you do not have one in place, we can help you get that done as well.

Beyond QITs, Slowik Estate Planning helps clients with a full range of estate planning needs, from wills and revocable living trusts to powers of attorney and even unique matters like pet guardianships. We take a comprehensive approach to protecting you and your family. Our office is in Atlanta, Georgia, and we are ready to help you take the next step. Call us today to schedule a consultation. Every family’s situation is different, and prior results in any case do not guarantee similar outcomes in yours.

FAQs About Qualified Income Trusts in Georgia

What is the income limit for Medicaid long-term care in Georgia in 2026?

In 2026, the income limit for Georgia Nursing Home Medicaid for a single applicant is $2,982 per month. This limit is set at 300% of the federal Supplemental Security Income benefit rate. If your gross monthly income from all sources, including Social Security, pensions, and VA benefits, exceeds this amount, you will need a Qualified Income Trust to become eligible for Medicaid long-term care benefits in Georgia.

Can a Qualified Income Trust be revoked or changed after it is set up?

No. A valid QIT in Georgia must be irrevocable. If the trust is revocable, Georgia Medicaid will treat it as a countable resource and it will not help you qualify for benefits. Once the trust is signed and in place, it cannot simply be undone. This is why it is so important to work with a qualified attorney before setting one up, to make sure the document is drafted correctly from the start.

Who can serve as trustee of a Qualified Income Trust in Georgia?

The Medicaid applicant or recipient cannot serve as their own trustee. The trustee can be a family member, a court-appointed guardian or conservator, or an agent acting under a valid Power of Attorney. In some cases, the nursing home may serve as trustee, but the nursing home cannot establish the trust itself. Choosing a responsible and organized trustee is important because that person must manage the trust account carefully every single month to keep Medicaid benefits in place.

Does a Qualified Income Trust protect money for my family after I pass away?

No. A QIT is not designed to preserve assets for heirs. Under Georgia Medicaid rules, when the Medicaid recipient passes away, the state is named as the beneficiary of any remaining funds in the QIT, up to the amount Medicaid paid for the recipient’s care. This is part of Georgia’s Medicaid estate recovery process. If protecting assets for your family is a priority, there may be other estate planning strategies worth discussing with an attorney, though those conversations should happen well in advance of a Medicaid application.

How quickly does a Qualified Income Trust need to be set up?

Timing is critical. A QIT cannot be backdated under Georgia Medicaid rules. It takes effect only in the month it is signed and completed by all required parties. This means that if your loved one needs nursing home care now and their income is over the limit, you should reach out to an estate planning attorney as soon as possible. Delays can result in gaps in Medicaid coverage and significant out-of-pocket costs for nursing home care during those uncovered months.

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