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Miller is not the more usual type of trust done to remove a person’s ownership of assets and have then retitled into and owned by the trust. Like placing a hiuse in a trust and ch age ig the title to reflect that, Miller is more a shift of where a guaranteed income source (SSA meets this requirement) is placed into (the Miller) on the behalf of the beneficiary and goes to be paid to a fixed institution on the behalf of the beneficiary. Miller set up dependent on just how your State deals with it…. Some have a form Medicaid has, others require an atty to do it. Also some States that do not at all allow for Miller, they usually do a Medicaid pooled trust. For example, NYS does pooled trust, but FL does Miller. Each State runs its Medicaid system uniquely. You will just have to research what’s what for your mom’s State.
ok so say, a Mom has $1500 in savings, gets $2345 SSA each month, and also $300 a month alimony and a small retirement of $755 a month. Mom’s mo income total = $3,400. Moms State does what the vast majority of States do and has its income limit at $2,829 and it’s asset limit of 2K. This mom is ok for assets as it’s $1500 so under the 2K max. BUT “over resourced” by $571.00. $571 fricking dollars. AND this mom is in a State that does Miller and it is done with only her SSA placed into it as those other 2 are not guaranteed. Voila! Mom now has only $1,055 income per month and under the $2829 income maximum. & so mom will have only $1,055 monthly income which will a psy all become the required Share of Cost of her income required t be paid to the NN. All she gets to retain is whatever amount of $ her State allows for a personal needs allowance. Like TX has its personal needs allowance at $75 a mo. So if this mom was in TX her Share of Cost required to be paid to the NH would be $980.00 ($1055 - $75). That $75 is the only $ she will have once on LTC Medicaid. And in theory the NH will cover all costs to provide for her care as everything will be billed to either LTC Medicaid or if it could be paid by health insurance then billed to Medicare or Medicaid as health insurance benefits.
Meanwhile that Miller that gets only her SSA $ will independently be paid to the NH she is in; and it will usually need to be direct deposited by SSA into a bank that participates in Miller, in ABLE bank accounts or other restricted accounts as it has the requirements that the $ is under the control of the State and upon her death any $ left escheates to the State.
Miller or pooled Trusts are done all the time. Lots of folks from their SSA retirement income alone make over the $2829 that most States place as an income maximum. Lots make SSA max income of $4,873 a month. But it’s still not enough $ to private pay for a NH as they run 7K - 15K a month. I’m mentioning this as being over resourced is not unusual. Get your Google on and do some research and I think you’ll find what the options are.
The other thing is the ability to go to the court and petition to have this lifelong alimony stopped. Ex - hubby would probably be grateful.
Ask him if HE would be willing to go in and petition with a letter from her confirming that is her choice.
I don't have any other ideas. This is a dilemma, for sure.