Who needs an Ohio Medicaid Qualified Income Trust (QIT)?
Ohio has a special income level for long‑term care Medicaid. Applicants with gross income at or below that level do not need a QIT. If your gross monthly income from Social Security, pensions, and other sources is above $2,901 in 2025, you establish a QIT to qualify for Medicaid payment of nursing home, assisted living waiver, or home‑care waiver services.
“Gross income” means the total amount before taxes, Medicare premiums, insurance, and other deductions are taken out, which is often higher than the amount actually deposited into your bank account.
What is an Ohio Qualified Income Trust?
A Qualified Income Trust is an irrevocable, Medicaid‑specific trust that holds only the income of the Medicaid applicant. The person applying for Medicaid is usually the Grantor, and a trustee (often a spouse or adult child) manages the QIT account according to Ohio Medicaid rules.
If the applicant cannot sign the trust, an attorney‑in‑fact under a properly drafted durable financial power of attorney or a court‑appointed guardian may be able to sign on their behalf. Many powers of attorney are defective in this respect, which is why at Golowin Legal we always bring this issue up to estate planning clients.
How does a QIT work in practice?
After the trust is signed, the trustee opens a separate QIT checking account that is used only for the Grantor’s income. Each month, the trustee deposits enough of the Grantor’s income into the QIT so that the remaining income outside the trust is under the Medicaid income cap.
Once the required amount is deposited into the QIT, that income is not counted when Medicaid determines eligibility, as long as all other requirements are met. Funds in the QIT are then used for specific, permitted purposes such as the Medicaid patient liability, medical expenses, and limited personal needs, following Ohio Medicaid allocation rules.
What happens to QIT funds after death?
By law, the State of Ohio must be named as the primary beneficiary of the QIT up to the amount of Medicaid benefits paid on the beneficiary’s behalf. In practice, if the QIT has been handled correctly from month to month, the account balance is usually very small at the time of death.
Because the state’s claim is limited to the remaining QIT funds and the amount of Medicaid paid, proper administration helps avoid unnecessary buildup in the account while keeping eligibility intact.
How Golowin Legal makes QITs easier
This practice helps clients throughout Columbus, Central Ohio, and throughout the state set up and administer QITs as well as assist with broader Medicaid 5-Year Planning. When assisting with a Qualified Income Trust, services typically include:
- Drafting a QIT that complies with Ohio Medicaid rules and fits your overall estate and asset‑protection plan.
- Providing a plain‑English explanatory letter and color diagram that show, step‑by‑step, what income goes into the QIT account and how payments should flow each month.
- Coaching the trustee on opening the QIT bank account, setting up deposits, and keeping the paper trail that caseworkers expect.
The goal is to make the QIT process as straightforward as possible so you can focus on care decisions rather than paperwork and technical rules. Rather than just providing a form, our goal is to help you understand the process and be set up to clearly understand what to do each month to maintain Medicaid eligibility.
