What is Quality Income Trust?

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Dear Crystal:

My parents have both had some serious health issues in recent years. I think in all likelihood, we will need to find a nursing home for them to move to in the very near future. My father is very unsteady on his feet and is falling quite often. Despite telling my mom over and over to call for help and not try to get him up on her own, she continues to try to assist him. As a result, she’s taken a few hard falls herself.

Several years ago, my parents sold their house and moved into an apartment. We’ve used a lot of the money from the sale of their house to pay for in-home care the past few years. While they do have some money left, it won’t last long if they are paying for a nursing home.

When my husband’s dad needed to move to a nursing home, we first had to spend down his assets so he would qualify for Medicaid. However, when I toured a nursing home last week for my parents, the social worker mentioned something called a Quality Income Trust. She explained that we wouldn’t have to spend down my parents’ assets like we did with my father-in-law.

What is this and how does it affect my parents?


An Overview of the Quality Income Trust

Dear Tina,

The Quality Income Trust (QIT) went into effect in Ohio on August 1st of 2016. It was a change to the Medicaid program that means older adults are no longer required to spend down their assets to qualify for aid.

Here are a few highlights of the trust:

  • A Quality Income Trust is a legal arrangement that can help seniors become or remain eligible for Medicaid.
  • As of August 1, 2016, people who receive Medicaid long-term care services and have an income higher than the Medicaid limit are required to deposit excess income into a QIT to keep their Medicaid coverage.
  • The QIT applies to seniors enrolled in Ohio’s Medicaid waiver programs. This includes PASSPORT, the Assisted Living Waiver program, Ohio Home Care Waiver and MyCare Ohio.
  • For seniors like your parents to receive Medicaid long-term care services, their income must be below the Medicaid limit set by the State of Ohio. If their income exceeds this amount, you must deposit the excess income into a QIT to stay or to become eligible for Medicaid long-term care services.
  • Money in a QIT can be used to pay for some expenses, such as medical costs, personal care, and bank fees to maintain the QIT.
  • It’s important to know that a QIT is irrevocable, and the State of Ohio is the primary beneficiary.  The QIT remains in effect until the person passes away. Any money left in the QIT is paid to the state, up to the amount Medicaid paid for the senior’s care.

If you need more information or have questions, there are two different resources you can turn to for help:

I hope this helps, Tina!

Kind Regards,

Crystal Moore