Do you have aging parents or loved ones in Delaware that will need help paying for their nursing care? If so, Medicaid may pay for their nursing care costs but you must qualify. If your income is too high for the state limits to traditionally qualify for Medicaid, there is a way to help.
Delaware is an “income cap” state and in order to qualify for Medicaid in Delaware, you must have no more than a set amount of total monthly gross income. If your total monthly gross income is above the state limit [currently set at $2,417.50 for 2025], then in order to qualify for Medicaid benefits you must setup an Irrevocable Income Trust also known as a “Miller Trust.” A “Miller Trust” is a special purpose trust set up and used in conjunction with a bank account to hold the excess monthly income that a person earns, over and above the state limit or “cap”. Miller Trusts allow individuals to receive Medicaid benefits for long term care services, like nursing home care, if their incomes are above the Medicaid eligibility limit. When a Miller Trust is established, the person’s income is deposited into the trust which is used to pay for the cost of their care.
What will a Delaware Miller Trust pay for?
The income deposited into the trust will be used to determine the individual’s Patient Pay Liability, which is the amount they are required to pay towards the cost of their care. However, before paying the Patient Pay Liability, the income can be used for other things such as:
● Community spouse – if the individual is married, the funds from the Miller Trust can be used towards the amount of money their spouse requires for monthly expenses, also known as a Minimum Monthly Maintenance Needs Allowance. If the spouse’s income is less than their monthly bills then the amount they fall short can be deducted from this trust account each month. Example – Mike enters a nursing home, his income is $2,500 and is entered into the Miller Trust. His wife Pat has an income of only $700 but her monthly expenses are $1,400. They can use $700 each month from his income to make up the shortfall of income for Pat.
● Medicare premiums
● Medical costs not covered by Medicaid. Upon the person’s death, funds remaining in the Miller Trust are used to reimburse the State’s Medicaid program for the cost of the care that the person received. Specific rules apply to the establishment and use of Miller Trusts. Anyone interested in setting up a trust should consult with an elder law attorney. Stand By Me cannot help to open a Miller Trust, but can help you to plan your budget while using a Miller Trust.
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