The Texas Department on Aging says the average cost for private-pay nursing home care in Texas is $3000 per month --got an extra $36,000 a year in your home budget? There aren't too many nursing home good deals, but the Miller Trust may be the exception. Through this legal document, my father now qualifies for full Medicaid nursing home benefits. I'm not a lawyer or offering legal advice, but my experience in this two-part column may save you money.
I was advised that the Miller Trust is a legal way to "get around" the income cap imposed by Medicaid to qualify for benefits. Dad qualified for Medicaid on every point except his monthly income which was about $200 per month over the $1500 per month cap. The Miller Trust is NOT a way to hide money or to shelter your assets.
An attorney specializing in elder law created the Miller Trust document for me, as dad's power of attorney, for $475. Before signing and notarizing it, I sent the draft to the legal department of my bank. They didn't require any changes to the Trust's language.
After the attorney and I executed the final draft, my bank and I set up the actual Miller Trust checking account with only a $5 monthly service charge. We arranged for direct deposit of dad's Social Security check each month with me as the Trustee. This allowed Medicaid to ignore that amount when calculating his monthly income which brought him under the cap.
The money in the Miller Trust can't be saved or accumulated. It must be used for the personal needs allowance of the resident, paid to the spouse as a "spousal allowance," or used for the nursing home or other medical care. If there is a spouse who meets Medicaid's definition of "impoverished" without the check that goes into the Trust account, the entire amount (less the bank service charge) may be paid to her or to him each month by the Trustee.
It was not easy, but we're saving about $3000 per month! From the initial attorney meeting until final Texas Department of Human Services (TDHS) approval took almost eight months. In the interim, you pay the nursing home. Call the Legal Hotline for Older Texans at 1-800-622-2520 for legal advice and attorneys offering reduced rates to Texans who are age 60 or over or are calling on behalf of one who is. Next month I'll cover the problems and objections we encountered and how they were overcome.
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