That statement is incorrect and leads to many veterans foregoing as much as $1949 of tax free income each month that can help pay for assisted living care.  But it is easy to understand why so many make this mistake.  It’s because the Medicaid waiver programs that pay for this type of care have an income cap of $2022 per month.  So naturally, the concern is that the additional VA income will push me over that income cap.

 Except that not all income is treated as income for Medicaid purposes.  The VA Aid and Attendance benefit falls into that category.  It does not constitute “countable income”.  In fact, there is a Medicaid Communication issued by the New Jersey state agency that administers Medicaid, clearly stating that the benefit will not be counted for financial eligibility purposes.  I should also note that Medicaid won’t deny an application if someone does not apply for VA benefits.  That can also be a point of confusion  since Medicaid does require applicants to apply for other benefits that they may be eligible for, such as disability. 

 Another point of confusion is that while the VA benefit is not counted for eligibility purposes, it is included with all other income when determining the amount of contribution towards the cost of care.  This is the cost sharing aspect to Medicaid assisted living benefits.  How much you pay for your own care and how much Medicaid pays depends on your income.  However, once VA receives notification of Medicaid benefits received it will reduce its pension to $90 per month.

 As you can see, it’s tough navigating through the long term care system alone.  It can cost you literally thousand of dollars a year if you don’t get the right information.

 There are a number of different VA programs, many which are not publicized.  This results in many veterans and their families losing out on benefits for which they are eligible.  The Aid and Attendance program is one such program.  Eligible wartime veterans can receive as much as $1954 per month of tax free income. 

 There are income and asset limits to qualify.  Single applicants can have no more than about $40,000 in assets and married applicants under about $80,000 (primary residence is exempt).  The income limits are too complicated to explain in a short post such as this, but before you jump to the conclusion that you do not qualify it is best to consult with a knowledgeable elder law attorney because so often restructuring your assets can result in immediate qualification.  For more information I suggest you sign up for my free e-course on VA benefits www.learnvabenefits.com/hauptman.

 So, on this Memorial Day, as you salute a veteran you can also do so much more by alerting your veteran loved one that help may be available.

The VA doesn’t do a good job of publicizing its benefits and services so getting accurate information is never easy.  There is a program of services under what the VA calls the Geriatric and Extended Care Program.  These include programs that provide care in a veteran’s home or in a community setting such as adult day care, specialized services for rehabilitation following, amputation, stroke, traumatic brain injury and spinal cord injury, physical therapy and home hospice care.  Keep in mind that the range of services can vary greatly depending on where you live and which health care network the VA has charged with providing those services.

Uncovering and understanding the eligibility requirements is the harder part.   Unlike the Aid and Attendance program which is available to veterans and their spouses, the Extended Care Program is only available to veterans who received a discharge under honorable conditions.  It is, however, not limited to veterans who served during wartime (again, unlike Aid and Attendance).  There is no length of service requirement for vets who enlisted before 1980.

There is a co-pay requirement applicable to the nonservice connected veteran, that is, a veteran who’s injury or illness is not linked to his military service (which is the case with most of our elderly clients).  In order to be eligible the veteran’s income must not exceed  the maximum annual pension rate for the Aid and Attendance program.  The co-pay generally ranges from $5 to $97 per day, depending on the particular service received.

What I concluded from my research so far is that  the Extended Care Program is another option, another piece of the long term care puzzle.  And with proper guidance our clients may be able to tap into a valuable source which will help lessen the risk that they will run out of money and options when they reach the next step in the long term care journey.

As is often the case with government benefits, the rules can be confusing.  Similar to the Medicaid program applicants must meet certain income and asset limits.  The pension amount is determined by a specific formula.  Unreimbursed medical expenses are subtracted from gross income.  That number is then subtracted from the maximum pension amount to determine the applicant’s pension amount.  It is important to understand that the cost of the assisted living facility and home health aides is usually counted as an unreimbursed medical expense.  In many cases, it becomes easy to qualify for the maximum pension amount.

There is also an asset limit, approximately $40,000 for a single individual, $80,000 for married couples.  Unlike the Medicaid program, however, there is no lookback period or penalty for transferring assets.  This means that one can transfer assets to get below the asset limits and immediately qualify for Aid and Attendance.

However, things are not that simple.  (They rarely are when it comes to the long term care system and government benefits).   Transferring assets can result in additional benefits from the VA but those same transfers will result in ineligibility for Medicaid.  Now, that’s not to say that one should forget about Aid and Attendance.  It does, however, require a carefully drafted plan so that should the applicant need the next level of care down the road (ie. nursing home care) the applicant will be able to qualify. 

Consulting with a knowledgeable elder law attorney who will help a family plan for the next level of care, not just the care that is needed now, is advisable.