Qualified Income Trusts for married couples in Florida

Whose income counts

For nursing home Medicaid and institutional hospice, DCF does not consider income owned solely by the spouse at home when deciding whether the applicant's income is within the limit. Income belongs to the person named on the payment or who holds title to the property that produces it. Income from a jointly owned asset is counted to whoever it is paid to; when it is paid to both spouses, half is counted to each.

So the QIT holds the applicant's income only. The spouse's Social Security, pension, or wages never go into it.

The allowance for the spouse at home

Once the applicant is eligible, DCF can set aside part of the applicant's income for a spouse living at home whose own gross income is below a State standard. DCF's formula adds the State's minimum monthly maintenance needs allowance and the spouse's excess shelter costs, then subtracts the spouse's total gross income. The result, up to a State cap, is the community spouse income allowance. DCF publishes the standard and the cap each year in Appendix A-9 of its policy manual.

The applicant's personal needs allowance is subtracted first, then the spouse's allowance, and what remains goes toward the patient responsibility. The spouse can refuse all or part of the allowance, and if a court has ordered support for the spouse, the allowance cannot be less than the order. This applies in nursing home Medicaid, institutional hospice, the long-term care waiver, and PACE.

Housing costs DCF counts

Excess shelter costs start with what the spouse at home pays for the home: rent or the mortgage payment (principal and interest), property taxes, homeowners or renters insurance, condominium maintenance charges, and mandatory homeowners association fees. Costs someone else pays do not count. If the spouse pays utility bills, DCF adds a standard utility amount rather than the actual bills; the utilities it recognizes are water, sewage, gas, and electric. DCF then subtracts a set share of the State's standard to find the excess.

Who can sign the trust

DCF's guidelines accept a QIT signed by the applicant's spouse, and no power of attorney is required when the spouse signs. The spouse still needs a way to move the applicant's income into the trust account each month, so the bank accounts and any power of attorney still matter.

Savings are a separate question

The QIT deals with income only. How much of the couple's savings the spouse at home may keep is decided under Medicaid's asset rules, not through the trust.

Questions

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.