### Understanding the Qualified Income Trust (Miller Trust)
If your gross monthly income exceeds the strict Florida Medicaid limit, you will face automatic disqualification. However, you can legally fix this issue by establishing a Qualified Income Trust (QIT), also known as a Miller Trust.
* **How It Works:** A specialized, legal trust document is drafted. A new checking account is then opened in the name of the trust.
* **The Monthly Mechanism:** Every month, the portion of your income that exceeds the Medicaid cap must be deposited directly into this trust account.
* **Permitted Disbursements:** The money placed inside the trust cannot be accumulated or saved. It must be paid out each month to cover approved medical expenses, patient responsibility costs to the facility, or an allowed spousal income allowance.
# Checklist: Permitted Florida Medicaid Spend-Down Actions
Before applying for long-term care Medicaid, ensure your excess resources are deployed legally. Use this checklist to safely lower your countable asset base:
* [ ] **Pay Down Legitimate Debt**: Liquidate outstanding credit cards, vehicle loans, or personal notes.
* [ ] **Enhance the Primary Homestead**: Invest in necessary home repairs, a new roof, or disability modifications.
* [ ] **Pre-Pay Funeral & Burial Plans**: Purchase irrevocable pre-need funeral contracts and burial plots for the applicant and spouse.
* [ ] **Purchase Personal Property**: Upgrade required personal comfort items, such as a specialized bed, clothing, or electronics.
* [ ] **Pay for Professional Services**: Fund necessary legal fees for Elder Law planning or private medical/caregiving fees.
⚠️ CRITICAL RULE: Maintain receipts and bank records. Florida reviews all statements, requiring formal proof for any expenditure over $200.