Understanding a Qualified Income Trust (QIT) and Its Use Qualifying for Medicaid


By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold, NJ Medicaid Attorney

The State of New Jersey has adopted the use of a Qualified Income Trust (QIT) to qualify for Medicaid Long Term Care.

QITs exist under Federal laws which have been adopted by New Jersey. A QIT is a trust document tied to a special bank account. The primary function of a QIT is to disregard an individual’s income above 300% of the Federal Benefit Rate (FBR). It is this disregard that allows an individual to qualify for Medicaid. In order for this income to be disregarded, it MUST be deposited monthly into a QIT bank account. Checks deposited into a QIT bank account must include the entire dollar amount of that income source, (for example, a social security check for $1,000 cannot be broken into $500 inside the trust and $500 outside the trust), the entire social security check must be deposited inside or outside the trust.

Understanding the Use of a Miller Trust Commonly
Known as a Qualified Income Trust

Medicaid eligibility for home based and assisted living MLTSS using a QIT will be approved after the following conditions are satisfied:

  • The Medicaid application is filed and successfully processed by the County Board of Social Services CWA;
  • The QIT is drafted, signed and funded and approved by the CWA to ensure compliance with federal regulations.
  • A Medicaid eligibility examination (Pre-Admission Screening (PAS)), for an institutional level of care, is conducted and approved by the Division of Aging Services.
  • QITs may be established for an individual by a family member or a lawyer. Here at Hanlon Niemann & Wright, we prepare many QITs and counsel hundreds of families each year on their use and the details of compliance.

All QIT documents must include the following provisions:

  • The QIT must contain only the income of the individual; no one else.
  • The QIT must not contain resources such as money from the sale of real or personal property or money from a savings account;
  • The QIT must be irrevocable;
  • The QIT must have a trustee to manage the administration of the trust and expenditures from the trust must be disbursed in compliance with federal and state law;
  • New Jersey must be named the first and primary beneficiary of any remaining funds up to the amount paid for Medicaid benefits upon the death of the Medicaid recipient;
  • Income deposited in the QIT can only be used for the specific Post-Eligibility Treatment of Income and to pay for the Medicaid beneficiary’s cost share.

The order of deductions that must be paid by the Trustee from the trust following Medicaid approval is outlined in federal regulations. They are as follows:

  • A Personal Needs Allowance or Maintenance Needs Allowance (based on your living arrangement);
  • A Spousal and family member maintenance allowances where applicable;
  • An Allowance for unpaid but approved medical expenses;
  • Health insurance premiums;
  • Cost share contributions for room and board or community residential expenses for home or assisted living care.

The trustee may be compensated if there is money remaining in the QIT bank account after all Post-Eligibility expenses and cost share are paid. The trustee fee may be up to 6% of the income deposited into the QIT bank account each month. All post-eligibility expenses and cost share expenses must be paid by the trustee whether the income is inside or outside the QIT bank account. If there is a balance left after these expenses are paid, it must remain in the QIT bank account.

Fred Niemann - Medicaid Lawyer in New Jersey

Fred Niemann, NJ Medicaid Lawyer

Contact Fredrick P. Niemann, Esq. on any questions concerning eligibility for NJ Medicaid or applying for Medicaid approval.

Call toll free (855) 376-5291 or email him at fniemann@hnlawfirm.com to set up an office consultation at your convenience.