Updated August 27, 2026. Quick answer: Tennessee’s QIT rule carries a reporting duty that catches families off guard: “the trust itself is a third party medical resource and must be reported to the TennCare Third Party Liability Unit”. The trust is not only an eligibility device in Tennessee; it is a resource TennCare tracks. “A QIT is a trust that is created specifically for the purpose of becoming eligible for TennCare Long-Term Services and Supports (LTSS).”
What Tennessee requires
| What the state sets out | What it says |
|---|---|
| Tennessee’s name for it | Qualified Income Trust (QIT) or Miller Trust |
| What it is for | “A QIT is a trust that is created specifically for the purpose of becoming eligible for TennCare Long-Term Services and Supports (LTSS).” |
| Who it serves | For individuals seeking LTSS whose gross income is over the income limit, the state allows the individual to create a QIT |
| Reporting duty | “the trust itself is a third party medical resource and must be reported to the TennCare Third Party Liability Unit” |
| Where the policy sits | TennCare HCFA Eligibility Policy Consolidated manual, the QIT section |
How it works in practice
- The third-party liability duty is the distinctive Tennessee obligation: “the trust itself is a third party medical resource and must be reported to the TennCare Third Party Liability Unit”. Failing to report is an omission with consequences separate from whether the trust itself is valid.
- The trust is tied to long-term services and supports: “A QIT is a trust that is created specifically for the purpose of becoming eligible for TennCare Long-Term Services and Supports (LTSS).” It is not a general fix for being over income on other TennCare categories.
- The trigger is gross income over the limit, and the state permits the trust rather than requiring a different route — the manual describes the state as allowing the individual to create one.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the Tennessee record.
What this page does not settle
- TennCare’s consolidated manual is revised in place and its QIT provisions have been amended more than once. The version read for this page is the consolidated manual as published on the date above; check the current revision before relying on a detail.
- This page reads one source: TennCare, HCFA Eligibility Policy Consolidated manual. It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A trust fixes an income problem and nothing else. The asset test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Related: Tennessee’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Tennessee’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.