Questions about Florida QITs
Zacharia Frey PLLC. Updated November 2026. Draft for attorney review.
General
- How do I know if my parent needs a QIT?
- Add up their gross monthly income from every source, before the Medicare premium or anything else is withheld, and compare it to Florida's income limit for long-term care Medicaid. If it is over the limit, a QIT is needed. The QIT Check on this site does that comparison, including the required distribution from an IRA.
- Which Medicaid programs require a QIT?
- Nursing home Medicaid (the Institutional Care Program), the Statewide Medicaid Managed Care long-term care waiver for care at home or in assisted living, and PACE all use the same income limit, and all require a QIT when income is over it.
- Can we set up the QIT after Medicaid is approved?
- The trust must be signed and its bank account open, and income must go into it, for each month you want covered. Income cannot be excluded until it is placed in the trust, and a trust cannot be funded retroactively. Start before the application is filed.
- Does the QIT have to be approved by DCF?
- DCF sends every income trust through its Region or Circuit Program Office to the Circuit Legal Counsel, who decides whether it qualifies. Keep funding the trust every month while that review is pending.
- Is a QIT needed for hospice?
- For hospice care in a facility, yes: DCF's income trust policy covers institutional hospice along with nursing home Medicaid, the home and community-based waiver, and PACE. It does not apply to community hospice.
- Does the QIT have to be witnessed or notarized?
- DCF's guidelines for reviewing income trusts say an income trust does not need the two witnesses a will requires. It must be signed and dated; DCF treats an unsigned or undated document as no trust at all.
- Does the trustee have to report to DCF?
- Yes. DCF's policy requires the trustee to provide quarterly statements showing the deposits made to the trust for each month. Keep every bank statement.
- What if my parent leaves the nursing home?
- A person discharged from a Medicaid facility may revoke the income trust if the trust document allows it. Florida Medicaid must be reimbursed before anyone else receives anything. If the person moves to home care or assisted living instead, the trust usually continues. The monthly deposit and the patient responsibility must be recalculated for the new setting, and the change must be reported to DCF.
- How much does a QIT cost?
- The QIT Check on this site is free. For a QIT Review or for preparing the trust, our office explains the fee by phone after learning about your family's situation, because the work depends on the income, the care setting, and whether a trust already exists.
- Can a QIT hold savings or the proceeds of a house sale?
- No. A QIT may hold only the applicant's income. Adding savings, sale proceeds, or anyone else's money means DCF will not treat it as a qualified income trust.
- Does an IRA count as income?
- Regular distributions from an IRA are income. If the person has reached the age when required minimum distributions begin, the QIT Check adds the monthly share of that distribution to their income. How DCF treats the account itself depends on whether it is in regular payment status; ask us about the account.
- Is the QIT Check the same as the QIT Review?
- No. The QIT Check is a free, three-question screen on this site that answers one question: does income appear to be over the limit. The QIT Review is legal work by the firm, built from your documents, that produces a written monthly plan.
- Does using this site make you my lawyer?
- No. Using this site or sending a request does not create an attorney-client relationship. An attorney reviews every request, and any engagement is agreed in writing.
Do I need a QIT
- Can I check online?
- Yes. The free QIT Check asks three questions: gross monthly income, the value of any IRA on December 31 of last year, and age at the end of this year. It answers yes or no based on the information you provide, and nothing you type leaves your browser.
- Is the QIT Check's answer final?
- No. It is only as good as the figures entered, and DCF decides eligibility. The QIT Review checks the figures against the documents.
What is a Qualified Income Trust
- Is a Miller Trust the same as a Qualified Income Trust?
- Yes. "Miller Trust" comes from the federal court case that led to the rule. Florida's DCF calls it a Qualified Income Trust or an income trust. Lawyers also call it an income-only trust or a (d)(4)(B) trust, after the federal statute that authorizes it.
- What happens if the trust is not set up correctly?
- DCF does not treat it as a qualified income trust and counts the income as usual. If the income outside the trust is still over the limit, DCF's guidelines enroll the person in the Medically Needy program instead, which does not pay for long-term care.
- Does a QIT protect savings or a house?
- No. A QIT holds income only. Savings, investments, and real estate are handled separately under Medicaid's asset rules.
- Does gross income mean before the Medicare premium?
- Yes. DCF counts the Social Security benefit before the Medicare Part B premium is withheld, and pensions before any insurance premium or tax is taken out. Using the bank deposit instead is the most common mistake families make.
QIT by care setting
- Is the income limit different for assisted living?
- No. The same income limit applies to nursing home Medicaid, the long-term care waiver at home or in assisted living, and PACE. What differs is the personal needs allowance, the patient responsibility, and how much should go into the QIT.
- What happens if we deposit too much at home?
- The extra stays in the trust or is paid out for allowed expenses. It cannot be returned to the person for living costs, and whatever remains at death goes to the State. The fix is to lower the monthly transfer.
Managing a QIT
- Does the QIT need its own tax ID number?
- In our practice the QIT account uses the applicant's Social Security number, not a separate employer identification number. Ask us if a bank tells you otherwise.
- Can Social Security be deposited straight into the QIT?
- No. Social Security must be paid to the person's own account. Set up an automatic transfer to the QIT in the same month.
- What if we missed a month?
- Call us. A missed month usually cannot be fixed by depositing late, but what to do next depends on the program and the DCF notices, and it should be handled before the next month closes.
Out-of-state powers of attorney
- Will the bank accept my out-of-state power of attorney?
- A bank may ask for an opinion of counsel before accepting a power of attorney from another state. Even when the bank accepts it, the question for a QIT is whether the document gives you authority to create a trust.
- My parent cannot sign anymore. What now?
- Send us the power of attorney. If it does not give trust-creation authority, we will explain the remaining options, including a guardianship limited to what is needed.
What to gather for a QIT Review
- Why do you need documents rather than our own figures?
- Because the bank deposit and the gross benefit are different numbers, and DCF counts gross. A plan built on the wrong figure fails in the first month. Checking the documents is the point of the review.
- I cannot find the Social Security award letter. What now?
- Social Security can issue a benefit verification letter, and an online my Social Security account can show it. Tell us when you call and we will work with what you have.
How to set up a QIT
- Can the QIT be set up before the Medicaid application is filed?
- Yes, and it usually should be. The trust has to be signed, its account open, and income deposited in each month for which Medicaid is requested, and DCF's policy expects deposits to begin even before its legal counsel approves the trust.
- Does the trust have to say how much will be deposited each month?
- No. DCF's review guidelines say the trust does not have to name a monthly amount. What matters is that the bank records show enough income deposited each month to bring the income outside the trust within the limit.
- Who reviews the QIT at DCF?
- The Circuit Legal Counsel, after the eligibility specialist forwards the trust through the Region or Circuit Program Office. DCF processes the Medicaid application once that review comes back.
What a QIT can pay for
- Can the QIT pay assisted living room and board?
- In assisted living, the facility's room and board is usually paid from the person's own account, not from the trust, and DCF builds the personal needs allowance in assisted living around the facility's basic rate. Putting too much into the QIT can leave too little in checking for room and board. Our guide to funding by care setting explains the balance.
- Can money in the QIT be given back to my parent for spending money?
- Not without consequence. Anything the trust pays directly to the Medicaid recipient counts as their income. The personal needs allowance is part of the person's income that DCF leaves for them; it is not something to draw back out of the trust.
QITs for married couples
- Does the spouse's income go into the QIT?
- No. A QIT holds only the applicant's own income. Putting anyone else's money into it disqualifies the trust.
- Can the spouse at home be the trustee?
- Yes. A spouse or an adult child is the usual trustee. The trustee must make the deposit every month and keep the records DCF asks for.
- Is the allowance for the spouse automatic?
- No. It depends on the spouse's own gross income and housing costs, so DCF needs proof of both. The spouse may also turn it down.
Serving as trustee
- Can the trustee pay themselves from the QIT?
- Ask before paying anyone other than a provider or an allowed third party. The trust exists to pay for the recipient's care, and every payment may be reviewed by DCF.
- What if the trustee can no longer serve?
- The trust document should name a successor trustee. If it does not, or the successor cannot serve, call us before the next month's deposit is due.
What happens at death
- Does the State take the person's house or other property through the QIT?
- No. The QIT's payback reaches only the money in the trust. Other property is handled under separate rules.
- Who sends the payment to Florida Medicaid?
- The trustee, from the trust account. DCF's instructions are to make the check payable to Florida Medicaid and identify the person by full name and Social Security or Medicaid number.
Miller trust vs. living trust
- Is a Miller trust the same as a special needs trust?
- No. A Miller trust holds only the person's income so they meet the income limit. Trusts that hold a disabled person's assets are a different kind of trust under different rules.
- Will my parent's living trust be a problem for Medicaid?
- The assets in it count, the same as if they were in the parent's own name. Whether that matters depends on the asset limit and the planning options, which is a separate conversation from the QIT.
Florida's income limit
- Is Florida an income cap state?
- Yes. Florida sets a hard income limit for long-term care Medicaid and uses the Qualified Income Trust for people whose income is over it.
- Does the income limit apply to a married couple together?
- For a married applicant in a nursing home, DCF does not count income that belongs only to the spouse at home when testing the applicant's income. Our guide for married couples explains how the spouse's income matters afterward.
- When does the limit change?
- Each January, when the federal SSI benefit rate is adjusted. A person a few dollars under the limit in one year can be over it the next.
You do not have to work through the QIT rules alone
Start with a review of your family's own figures: whether a QIT is needed, how much goes in each month, and which account pays each bill. Our office calls within one business day. Nothing is charged online.