Yet,  in Texas and 20 other states, your income could be too high to qualify for help but too low to pay the full costs of care. Even if an elderly person meets the asset and health care requirements, if the applicant’s income is over the limit, they won’t get a dime from the Medicaid program.

Doesn’t sound very fair does it?

The rest of the states will offset a person’s income with their costs of care to determine income eligibility. That makes perfect sense.  It’s simple math. They net income against the costs of care. If the result is under the income limit, you satisfy income requirements.   Not in Texas!

Medicaid income rules say you  don’t qualify if your gross income is a penny over the limit.

Single people whose income is “too high” but without sufficient assets to pay for care are then forced to rely on the generosity of family and friends. Usually the financial burden falls on the adult children. If the children are unable to pay the monthly nursing home fees they bring the parent home. Not only are their lives forever changed, the quality of care available for the patient can suffer. For a married person, the spouse suffers the terrible dilemma of depleting limited assets to pay the nursing home leaving no money left for his or her needs.

A Miller Trust solves the problem in both cases.

The trust is an irrevocable trust that allows a person with “excess income” to become income eligible by running their income through a bank account specifically set up for that purpose.  Typically, all of the patient’s income is deposited into a special checking account. The patient’s nursing home bills, medical insurance premiums and a personal needs allowance are paid from the trust bank account according to strict Medicaid rules.

Medicaid income rules are complicated. Correctly setting up the trust and its attendant bank account is critical to getting eligibility approved.  That’s why using an experienced elder law attorney like me is such a good idea.

Have a question about Miller Trust or qualifying for Medicaid in Texas. Let’s chat. Call today. 713-970-1300.

Just as most doctors are not skilled in every facet of medicine, most attorneys are not skilled in every facet of elder law.

You want someone who is familiar enough with the problem you need solved to know how other aspects of the law might impact the steps you are considering.

As seniors age, they frequently find themselves dealing with complicated financial and health issues. Typical dilemmas involve retirement, end-of-life decisions, Social Security benefits, estate planning, long-term care, Medicare benefits, Medicaid coverage, nursing home care, in-home health care, powers of attorney, and healthcare directives. These get complicated. That’s where the advice of a reliable elder law attorney may help.

Attorneys that practice as elder care attorneys handle specific legal issues faced by an elderly population.

For example, a senior interested in updating a will but has an ailing spouse is better served by an elder law attorney well-versed on the impact Medicaid might have on that spouse’s future lifestyle.

Houston elder law attorney Michael L. Holland helps seniors of modest means preserve their resources, protect their hard-earned life savings from expensive costs of long-term care and guides families through the probate process.

Getting competent legal direction makes the entire process smoother and provides the best possible final result for the elder and his or her family.

Michael Holland provides the following services:

• Advise on protecting assets to avoid impoverishing one spouse when the other needs nursing home care
• Filing for Medicaid assistance
• Long term health matters
• Disability planning through financial and health care powers of attorney
• Incapacity planning through the use of living wills and living trusts
• Estate planning through the use of trusts, wills and other legal instruments
• Probate
• Questions about nursing home issues including patient rights and quality of care

While elder law is itself a legal niche, it also has sub-specialties. Sub-niches included among elder law include:

• Social security claims for benefits
• Tax planning
• Guardianship
• Estate trust administration
• Elder abuse
• Protecting seniors against fraud

When you call Holland Elder Law for an appointment, feel free to ask whatever question you have about the services I provide. I want you to be happy with the advice I provide. If I am not the right fit, I’m happy to refer you to an attorney I believe may better serve you.

Keep in mind that a good attorney keeps a full schedule. You’ll likely speak with my legal assistant when you call to set an appointment. That assistant should be able to answers questions you have about the practice or be able to get the answers for you quickly so you can decide if you want to schedule the appointment.

To find out what an elder law attorney can do for you, give me a call at 713-970-1300. I welcome your call.

One of the most persistent myths is that a Miller Trust in Texas can protect assets from Medicaid.

I don’t know why this misunderstanding persists, but it does.

The truth is simple: you cannot use a Miller Trust in Texas to shelter assets. If you try, you invalidate the trust and lose benefits. For families who don’t know the rules, the consequences can be serious.

*Been told income is too high to get Medicaid?
Use my 100% guaranteed Miller Trust.
Put an end to high nursing home bills and sleepless nights. 713-970-1300

How a Miller’s Trust Will Help You Get Medicaid in Texas

Federal and Texas law limit how much monthly income you can have and still get for this Medicaid nursing home benefits. The income limit is low, well below the average monthly cost of nursing home care. Years back, this restriction would keep patients from becoming Medicaid eligible.

In 1993 Congress established laws to address the problem. The new rules allow applicants to set up a special purpose income trust – a Miller Trust. The name derives from the family who brought suit against the system. Thankfully, they won.

The legal description for this type of document is a Qualifying Income Trust. The name spells out the only purpose of the trust. It’s designed to help someone become income eligible for benefits.

A basic limitation of Miller Trusts is that only income of the person needing care can go into it. Medicaid’s income limit for 2023 is $2,742 per month. If a person has income over the threshold, the only way to become eligible is to set up a Texas Miller Trust. If you have too much income to qualify but too little to pay the large nursing home costs, you can get the financial help you need.

Without a Miller Trust, you can’t.

That is why it’s so important to put one of these trusts in place. But you must do it in the right way. Unless you’re using an Medicaid planning attorney in Texas skilled with these documents, you can get this wrong. Only the income of the person needing care can be deposited.  Medicaid rules deem assets in the trust as “wrong money.” If you put the “wrong money” into a Texas Miller Trust Medicaid will deny the application. Denials are a costly mistake. You ruin your chances of qualifying for Medicaid money to pay those high nursing home costs.

How Income Trusts Work

The Miller trust document establishes a special checking account. The terms of the trust legally redirect monthly income away from the care recipient. Instead, the patient directs his or her income into a new checking account. When properly the character of the income changes under Texas Medicaid Income rules.

Excess income no longer prevents eligibility. The purpose of a Miller Trust is not to shelter the income. It acts as a funnel instead. Rules restrict how the income deposited in the trust account can be used. The funnel follows those rules to channel money flows from the patient to medical providers.

This approach works because the language of the trust recycles the money back out to help the patient pay nursing home and medical expenses. Income is no longer considered for eligibility purposes. It is considered, however,  when the state calculates how much the patient pays for care.

Income deposits into the trust may also provide funds to a spouse if the patient is married. In Texas, Miller Trust funds can also be used to pay for health insurance and Medicare premiums. Medical costs not covered by Medicare and Medicaid can also be paid from the trust. Rules also allow a $60 personal needs allowance for the patient.

Miller Trust Funding Mistakes

Another type of mistake families make is setting up the trust incorrectly. The benefits of a Miller Trust in Texas can be lost by not understanding the language required to establish the trust in the first place.  The rules for Texas Miller Trusts are precise. The problem is most don’t understand the rules.

One mistake I see has to do with the amount of money people put into the Medicaid trust. Sometimes they “round off” the amount. Sometimes they put only a part of a Social Security or retirement check into the trust. When the deposited amount differs from what the law requires, the agency caseworker voids the trust. Caseworkers may view an incorrect deposit as attempt to protect the income.

This small change can mean losing thousands of dollars of financial help.

Another mistake is people try to put funds other than income into their trust bank account. Miller Trusts are income-only trusts. The monies that go in must only come from the patient’s income. Putting other money into the account is a big mistake. When you place other anything else in the trust you run the risk of voiding the entire trust. Examples of disqualifying income include income tax refunds, some annuity payments, vocational rehabilitation or some financial help from the Veteran’s Administration. This simple mistake translated into losing Medicaid eligibility.

If you need a Texas Miller Trust, work with an elder law attorney who understands Medicaid rules. A skilled attorney will help you avoid small mistakes that lead to big problems. Something as simple as not depositing income by the last business day of the receipt month can cause problems. Some pension benefits are received the last day of the month. If the deposit isn’t made during the same calendar receipt month, Medicaid policy requires the State to count the income. Eligibility can be lost.

Setting up and funding a Miller Trust account can be tricky. Simple missteps lead to losing of thousands of dollars of benefit eligibility. ..money you can’t recover. There’s a easy way to avoid each of these serious blunders. If you need a Miller Trust to qualify for Texas Medicaid, hire an elder care attorney. Follow the advice of a lawyer with extensive Texas Miller Trust experience. You’ll be able to qualify faster, save money and reduce the emotional stress of the process.

Miller Trusts in Texas: Why Timing Is Important

A misunderstood ideas is about the best time to set up a Miller Trusts to become eligibility for benefits.  Anyone who applies for Medicaid and has a gross monthly income over the limit (for 2019, $2,313) won’t qualify without a properly funded Qualifying Income Trust (the formal name for a Miller Trust).

Once you’ve realized you need a Miller Trust to get help with those high nursing home bills, the next question is when to start the process.

Luckily,  Texas Medicaid policy allows you to set up a Miller Trust as late as the last day of the month in which eligibility is sought. For example, if you need eligibility in October, you have until October 31 to get the Trust document written and signed and the bank account open.  This rule is particularly helpful when a patient’s skilled benefits end after the first of the month. If you find yourself in that situation, you’ll face several weeks of paying nursing home costs out of your pocket.

That’s where this rule comes in handy.

The “end-of-the-month” Texas Miller Trust rule means the patient can start Medicaid benefits the day Medicare benefits end. While this rule can be helpful, the best timing is to have the trust executed the month before benefits are desired.

Monthly income deposited in the trust bank account needs to be coordinated with the creation of the trust.  Coordinated poorly and you risk losing benefits and paying a nursing home bill that can be several thousand dollars. Setting up the trust early also avoids additional stress and worry. With the Trust properly in place, you have one less financial issue to deal with.

Another advantage? Having the Trust prepared the month before allows an experienced elder law attorney to relieve the burden of high care costs as soon as legally possible. The attorney can provide clear and timely instructions for qualifying for Medicaid benefits.

You may still get benefits if the trust is set up the month of the Medicaid application but you expose yourself to a potentially costly mistake. Receiving and paying for care outside the trust means you can permanently lose benefits for that month.

Difference #1:
The bank accounts opened to fund a miller Trust operate more like a “representative account” for the payment of disabled person’s expenses rather than a typical asset-type trust account.  This is an income only trust. Because there are no significant assets placed in the trust there are none of the usual trust management issues.

Difference #2
For income tax purposes, the Miller Trust bank account is considered a “grantors trust”.  As such, there is no separate trust tax ID number required.  The bank should use the Social Security number of the grantor for the account.

Unfortunately, some bank personnel confuse the setup of an income only trust with that of an asset trust.  They will insist that you obtain a separate tax ID number.  If the bank insists on a separate tax ID number, you incur potentially costly delay waiting for the tax number to be issued.

We even had experiences at the same bank branch where one bank representative knew how the bank should open the trust account and others didn’t.  It can be very frustrating.

Difference#4-
The Miller Trust bank account must be titled as a “trust account.”  For example, “the John Smith Income Trust”, where John Smith is the grantor of the trust (the grantor is the person for whom the trust is established).

Difference#5-
Only the person named as the trustee (the person responsible for managing the trust account) is authorized to sign checks.  No other individual can write checks on the trust account, not even the grantor.  The trustee will receive the monthly statements. Because the State may ask for an accounting, you should safeguard the monthly statements along with an itemized account of how the money is spent on the patient’s behalf.

When you pass away, the people you leave behind will have much to deal with. If you do not leave a written Will, they may be faced with an expensive administration of your estate with a judge deciding how to divide your estate. By creating a valid Will you can save them the frustration of sorting out your estate in the midst of their grief. In probating Wills for my clients, there are several considerations to address. Who will inherit your estate? Who will be the guardians of your minor children? What will happen to your real estate or your bank accounts? How will your family move forward if your assets are locked in probate? People that do not provide for these contingencies before their death leave a major problem for those they leave behind. Once you are deceased, many of your assets can be frozen and the easiest way to get those assets is to probate a Will.

I, Houston probate attorney Michael L. Holland, have more than 25 years of experience helping my clients take care of these types of legal matters. I will work with you to draft a Will that outlines your wishes and assist your loved ones during the probate process when that day arrives. I also probate Wills in the probate court for those loved ones left behind.

Call 713-970-1300 to schedule a free consultation at my Houston probate law firm office.

Now Is the Time to Create Your Will

At least once a week I hear someone say “I’ll make a Will next month.” But as one month leads into the next, they never make the time to create this important document. All of us hope that we will have some warning before we pass away and will be able to dash to the probate attorney’s office to make the arrangements, but the reality is that none of us know what the future holds and when our time is up. Most people assume they will grow old and die of natural causes at an advanced age. However, the reality of the situation is that many people die prematurely as the result of any number of reasons.

By having a Will prepared you are taking the opportunity for reflective asset protection before and after your death.

Putting together a Will or a Physician’s Directive or a Living Will or Powers of Attorney are not as time-consuming and expensive as you might expect. Now is the time to protect the people you love and make your wishes known.

Personalized Estate Planning

Making a Will is a very personal matter. As your probate lawyer, I will work directly with you every step of the way to make sure that your wishes are followed. To see that your children are provided for and the documents provide for your wishes in such a manner that they will be legally
carried out. A Texas Will is extremely important if you wish to have a say in how your estate is distributed.

Together, we will draft a Last Will and Testament that addresses everything. We will name your “executor” (the person who will be responsible for administering your Will) and decide who will receive your estate. If you own property at the time of your death, your Will can give the executor
the ability to sell the home if necessary (or transfer title to your beneficiaries). Your Will can give the necessary people access to your bank accounts. Your Will can name the guardians for your minor children and provide trusts for those children. We can also make special provisions in
your Will for special bequests in order to give specific mementos to those friends or distant relatives to let them know how you felt about them. Texas probate law provides for a multitude of scenarios following someone’s demise.

You may have a situation where a loved one has already passed away and left no Will. There are other ways of dealing with these situations such as a Small Estate Affidavit, Determination of Hiership, and Independent Administrations.

My clients appreciate my hands-on, personalized approach to estate planning and probate. Although it may sound trite, I care about my clients, their families and their long-range goals. I pride myself on placing my client’s priorities first. At my law offices, you will talk with your
attorney – me – not support staff or associates. I listen to your concerns and I personally draft your Will and other supporting documents. I am the attorney that will go to the court hearing with you.

Can I plan ahead and avoid probate?
Yes. Some of my clients elect to have us help them position their assets in a way that allows them to continue to enjoy the benefits of all they have, but in such a manner that avoids the need for probate. Probate usually costs your loved ones money and time – and usually at a time when they are overcome from the grief of losing you. Some of our clients, approach us asking for help in setting up their estate in order to save their loved ones the necessity of probate. It makes perfect sense. Factors in determining whether to plan to avoid probate depends on a number of factors – such as health, age, and the assets you own. If you are 40 years old or more, you may want to do some planning to avoid probate. Call me at 713-970-1300 for your free probate assessment.

Call me at 713-970-1300 if you have questions, I will be happy to answer them at no charge. If you need me to help you create a Will or to probate a Will or help with any type of probate matter, I will schedule a free initial consultation with you to begin the process.

Medicaid Nursing Home Services in Harris County, Texas

You can qualify for financial help to pay the high cost of Texas Medicaid approved nursing homes. But, it’s important to know how Medicaid and a nursing facility work before you start working on the application. No matter how you slice it, Texas skilled nursing facilities are expensive.

*How much sleep did you lose last night worrying about nursing home costs?
Let me guide you. Free Medicaid Eligibility Assessment. Call me now at (713) 970-1300

If you don’t have the money saved to pay for long term nursing home care, Medicaid is there for you and your family. If you fail to understand even the basics of Medicaid eligibility, you could find your application to the Medicaid program denied.

To get all the Medicaid nursing home benefits your family member is entitled you need to follow these critical 8 steps.

Step 1: Learn about the differences between Medicare and Medicaid.

How each agency will cover nursing home care is different. Medicare only provides a limited amount of benefit that cover nursing home care. Congress created the Medicaid program as a safety net for the elderly and people with disabilities. Medicaid nursing home benefits is part of that program. And, it’s the only government program that will cover long term nursing home care

Step 2: Learn about Medicaid’s eligibility requirements and restrictions.

The government says if you want Medicaid to help pay nursing home care, you must meet four basic tests. The four tests include:

• The patient’s gross monthly income has to be less than $2,742.
• The assets of the person needing care must be less than $2,000.
• There must be a proven medical need as determined by the state
• The patient must be in a Medicaid approved nursing home.

Step 3: Ask for a coy of the Medicaid application

Get a copy of the Medicaid application. Medicaid certified nursing homes can give you a copy. You can also get it from a local office of Texas Health and Human Services or online . The Texas Health and Human Services commission administers financial benefits for skilled nursing facilities.

Step 4: Complete the form carefully.

The Medicaid nursing home application is long and complicated. To avoid being denied Medicaid nursing home benefits, you need to fill it out accurately. Be sure you understand each question before answering it. If you make a mistake on the application, the Texas Department of Health and Human Service can deny your request. Completing the form the wrong way can delay the approval of Medicaid nursing home care benefits. With monthly costs running $6,500 and more, losing benefits can be costly.

Step 5: Confirm the patient meets income and asset restrictions

Double check that the patient is within the income and asset limits for Medicaid nursing home eligibility. Don’t make the mistake of submitting an application that will be denied. There are serious financial and emotional losses at stake. To avoid making this costly error, get professional advice on Medicaid nursing home eligibility. If you are uncertain you’ll qualify, contact a Houston Medicaid attorney for help.

Step 6: Provide documents supporting answers in the application

Be prepared to provide documentation supporting the answers in the application. The rules of gaining Medicaid nursing home eligibility are strict. You will need to be prepared to give proof that supports your answers. At a minimum you need to provide:

• Statements for all financial assets for the current month and the three months before your application
• All deeds proving real estate ownership
• Current proof of income
• The most recent awards letter from Social Security
• Copies of all life insurance policies and annuity contracts
• Titles to all automobiles and paperwork proving their value
• Driver’s license
• Medicare card
• Social Security I.D. card
• Proof of health insurance coverage from Medicare, Medicare supplements and group health insurance

I can’t stressed enough that having proof to support your application is key. Texas Medicaid case workers have a “document or deny” attitude toward Medicaid applications. They will deny the application if you fail to provide accurate and complete verification documents on time.

Step 7: Keep copies of all documents you send

Make copies of all paperwork that you submit. The agency loses paperwork a lot. You have a so much riding on your application being approved. Having a second set of copies means that you can easily replace any documentation that gets lost. It will cut down on frustration and keep your application on track.

Step 8: Decide how to pay the costs of skilled nursing care until Medicaid approves

Anticipate how you will pay the cost of skilled nursing care until Medicaid approves. Those costs are your responsibility until the State approves Medicaid nursing home benefits. If you can’t afford to pay the entire monthly amount due, you still have options. Some Medicaid approved nursing homes offer something called “Medicaid pending”. The “pending” status means the nursing facility will accept a payment that’s less than the full amount until you are approved. The arrangement it like a loan until your case worker determines eligibility for benefits. With Medicaid pending you are still responsible for the full fee. Once Medicaid approves the application, the nursing home sends the bill to the state and eliminate the debt.

Remember to make sure the skilled nursing facility you select is a Medicaid certified nursing home. If the nursing home is not approved for Medicaid reimbursement, nursing home residents there will not get Medicaid assistance. With the high costs of Texas skilled nursing facilities, having access to financial assistance through Medicaid can make a huge difference in providing much-needed care and support for an elderly family member.

By understanding the basics of Medicaid eligibility and following the 8 steps outlined for successful application, individuals and families can ensure that they have all the skilled nursing benefits their loved one may need. Medicaid coverage for nursing home residents covers more than the cost of nursing home services needed. Also provided are support for Medicare premiums and co-payments, personal care services and rehab services.

Medicaid can provide invaluable assistance to those who are unable to pay for long term care on their own but, the process of applying for Medicaid nursing home eligibility takes a lot of time.

You’ll have a lot of forms to fill out. The key when going through the process is to have everything in order. Take your time and be patient. By paying attention to the small details, you can save money and time.

After you send in your paperwork, it’s normal to start worrying. Many people lie awake at night, afraid that they have made a mistake. The paperwork that you have to fill out to cover nursing home cost is tedious. The rules sometimes seem like they don’t make sense. It can be tempting to ask your State of Texas Medicaid caseworker for help.

Don’t do it. That’s not what they are there for.

They are not allowed to guide you or give you advice. Their job is to decide whether the information you’ve provided meets the agency’s financial and health criteria for nursing home services. Nothing more. Even a “minor” error can cause an application to be delayed, or worse, denied. A denial means you are on the hook for all nursing home costs.

That’s why so many families turn to us for help preparing and submitting their applications. Interested?

If so, call us at 713-970- 1300. We’ll be glad to help you.

The bank accounts opened to fund a Qualified Income Trust (the technical name for a Miller Trust) operate more like a “representative account” for the payment of a disabled persons expenses. It is not a typical asset-type trust fund.  They are considered an income only trusts. Because there are no significant assets placed in the trust there are none of the usual trust management issues you would encounter when assets are involved.

Unfortunately, some bank personnel confuse the setup of an income only trust with the administrative requirements of an asset trust.

You may find the banker will incorrectly insist you obtain a separate tax ID number.  For income tax purposes, the Miller trust bank account is considered a “grantors trust”.  As such, there is no separate trust tax ID number required.  The bank should use the Social Security number of the grantor for the account. When the banker demands a different tax identification number, you lose valuable time qualifying for Medicaid nursing home support. Although the IRS typically responds fairly quickly, you run the risk of a potentially costly delay waiting for the tax member to be issued.

Because Miller Trusts are used by a small population of people who need nursing home care, most bankers are not familiar with the steps for setting up  Miller Trust bank accounts in Texas. We have even experienced where one bank representative at a location knew how the bank should open the trust account and others didn’t.  It can be very frustrating. By the way, the type of account I recommend is either a checking account or a money market account with check writing access. Keep these four points  in mind when you set up and manage the account:

1. The Miller Trust bank account must be titled as a trust account.  For example, “The John Smith Income Trust”, where John Smith is the grantor of the trust (he grantor is the person for whom the trust is established).
2. Only the person named as the trustee (the person responsible for managing the trust account) is authorized to sign checks.  No other individual can write checks on the trust account, not even the grantor.
3. Do not attach a debit card or credit card to the account.
4. As trustee you will receive the monthly statements. Because the State may ask for an accounting, you should safeguard the monthly statements along with an itemized account of how the money is spent on the patient’s behalf.

These are the main points to keep in mind to avoid errors getting your trust established properly.  I’ve only skimmed the surface about Miller Trust bank accounts in the short space available here.  The main point to understand is accounts set up to fund a Miller Trust are different from regular bank accounts. That’s why it’s a good idea to work with an Texas elder law attorney who understands  how and when these accounts should be set up.