Iowa Miller Trust Cap Raised By Recent Legislation

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In order to qualify for Medicaid assistance benefits to pay for nursing facility or Home and Community-Based Services expenses (Medicaid Waiver), applicants must meet certain requirements for income and resources. An applicant’s gross income needs to be less than $2,163.00 in order to meet these qualification standards.  If an applicant’s gross income exceeds $2,163.00, the applicant needs to establish a Medical Assistance Income Trust (commonly known as a Miller Trust or Qualified Income Trust).  Once this Medical Assistance Income Trust is in place, an applicant can qualify even though their gross income is above $2,163.00.

For reasons unknown to us, there is a monetary cap on the Medical Assistance Income Trust.  In 2014, this number was $4,642.00.  Therefore, if an applicant’s income was above $4,642.00, the applicant could not become eligible for Medicaid.  Many applicants are well under this income limit.  However, it places high income individuals – with no other resources – in a precarious position because, there was no way for them to qualify for Medicaid.

Fortunately, this cap was recently changed by the Iowa Legislature with the passing of Iowa House Bill HF 2159.  This bill contains an additional appropriation to increase the Miller Trust upper limit of $4,642.00 to 125% of the current Iowa statewide average nursing facility cost of $5,057.65.  Therefore, the new upper limit will be approximately $6,322.06 as of July 1, 2014.  This will ensure that almost all applicants who cannot continue to private pay will be eligible for Medicaid, even though they have a high income.

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