Florida QIT glossary

The words DCF, nursing homes, and lawyers use in a Qualified Income Trust case, defined in plain English. Each term links to the guide that explains it in full.

Qualified Income Trust (QIT)

Also called: Miller trust, income trust, income-only trust, (d)(4)(B) trust

An irrevocable trust, established for the benefit of a Medicaid applicant, that holds only the applicant's income and repays the State at death up to the total Medicaid paid. Income deposited in it each month is not counted against Florida's income limit for long-term care Medicaid. Read more

Miller trust

Another name for a Qualified Income Trust, taken from the federal court case that led to the rule. Florida's DCF uses the terms qualified income trust and income trust. Read more

Income limit

Also called: income cap, ICP income limit, 300 percent of the federal benefit rate

The most gross monthly income a person can have and qualify for Florida nursing home Medicaid, institutional hospice, the home and community-based waiver, or PACE: 300 percent of the federal SSI benefit rate. It changes each January. Read more

Gross income

Income before anything is withheld. For Social Security, the benefit before the Medicare Part B premium is deducted; for a pension, the amount before tax and insurance. DCF uses gross income to decide eligibility for nursing home Medicaid, hospice, and the waiver. Read more

Federal benefit rate (FBR)

The monthly federal Supplemental Security Income payment for one person. Florida's income limit for long-term care Medicaid is 300 percent of it, so the limit moves when the federal benefit rate is adjusted each January. Read more

Patient responsibility

Also called: share of cost

The part of a Medicaid recipient's monthly income that goes toward the cost of care, paid to the nursing home, the waiver provider, or the PACE organization. DCF figures it from all income, inside and outside the QIT, minus the personal needs allowance, any spouse or family allowance, protected income in a month of admission or discharge, and uncovered medical expenses. Read more

Personal needs allowance (PNA)

The part of a Medicaid recipient's income DCF leaves for the person's own needs. It differs by setting: a small fixed amount in a nursing home; at home in the long-term care waiver, an amount equal to the income limit; in assisted living, an amount built from the facility's basic room-and-board rate plus a share of the federal poverty level. Read more

Institutional Care Program (ICP)

Also called: nursing home Medicaid

Florida's Medicaid program that pays for nursing home care. A person over the income limit qualifies through a QIT. Read more

Statewide Medicaid Managed Care Long-Term Care (SMMC LTC)

Also called: long-term care waiver, home and community-based services (HCBS) waiver

Florida's Medicaid program for long-term care at home or in an assisted living facility, delivered through managed care plans. It uses the same income limit as nursing home Medicaid. Read more

PACE

Also called: Program of All-Inclusive Care for the Elderly

A program that provides medical and long-term care through a PACE organization, usually while the person lives at home. It uses the same income limit, and patient responsibility is paid to the PACE organization. Read more

Institutional hospice

Medicaid hospice for a person in a nursing facility. DCF's income trust policy covers it; it does not cover community hospice. Read more

Community spouse

The spouse who lives at home while the other spouse receives long-term care Medicaid. Read more

Community spouse income allowance

Part of the Medicaid recipient's income set aside each month for a spouse at home whose own gross income is below a State standard. DCF figures it as the State's minimum monthly maintenance needs allowance plus the spouse's excess shelter costs, minus the spouse's gross income, up to a State cap. Read more

Minimum monthly maintenance needs allowance (MMMNA)

The State standard DCF uses in figuring the community spouse income allowance. DCF publishes it each year in Appendix A-9 of its policy manual. Read more

Excess shelter costs

The part of the spouse at home's housing costs (rent or mortgage, property taxes, homeowners or renters insurance, condominium maintenance, mandatory association fees, and a standard utility amount) above a set share of the State's standard. It increases the community spouse income allowance. Read more

Uncovered medical expenses

Health insurance premiums, deductibles, co-insurance, and medically necessary care Medicaid does not pay for, paid from the recipient's own funds. DCF subtracts them in figuring the patient responsibility. Read more

Medically Needy

A Florida Medicaid program with a monthly share of cost. When income outside an income trust is still over the limit, DCF's guidelines enroll the person in Medically Needy instead of long-term care Medicaid. Read more

Trustee

The person who manages the QIT: makes sure the monthly deposit happens, pays the patient responsibility and allowed expenses to third parties, provides quarterly statements of deposits, and pays the balance to Florida Medicaid at death. Read more

Irrevocable

Unable to be revoked. A QIT must be irrevocable, though it may allow amendments that do not include a power to revoke. Read more

Circuit Legal Counsel review

DCF's legal review of every income trust. The eligibility specialist forwards the trust through the Region or Circuit Program Office, and the Circuit Legal Counsel decides whether it is a qualified income trust. Read more

DCF

Also called: Florida Department of Children and Families, ACCESS Florida

The state agency that decides Medicaid eligibility in Florida, including whether a trust is a qualified income trust.

AHCA

Also called: Agency for Health Care Administration

Florida's Medicaid agency. A QIT's balance at death is paid to Florida Medicaid through AHCA's third-party liability contractor. Read more

ESS Program Policy Manual

The manual DCF eligibility staff follow in deciding Medicaid eligibility. Its income trust policy is passage 1840.0110, and its guidelines for reviewing income trusts are Appendix A-22.1.

Form CF-ES 2356

Also called: Third Party Recovery Transmittal

The DCF form used to send a copy of an approved QIT to AHCA's third-party liability contractor. It also carries the mailing address for paying a QIT's balance to Florida Medicaid at death. Read more

Durable power of attorney

A document that lets an agent act for a person and survives the person's incapacity. To sign a QIT as agent, the document must give authority to create a trust. Read more