Planning in Alaska should begin with the income-cap rule rather than a generic spend-down strategy. A current 2026 reference reports a $2,982 monthly individual income limit and a $2,000 countable-resource limit for Nursing Home Medicaid and HCBS waivers, and it notes that someone over the income limit may use a Qualified Income Trust — a tool a 2025 presentation identifies specifically as a Medicaid Qualifying Income Trust, or Miller Trust, and explicitly not a resource shelter.
Alaska Law Help describes the Miller Trust as irrevocable, funded only with income rather than resources, and generally required to pay any remaining funds to the state when the beneficiary dies. That structure makes it worth reviewing carefully before an application goes in — it functions nothing like a simple checking account or a general estate-planning trust.