The Veterans Administration estimates that in 2005 there were 4.9 million veterans aged 75 and older. The Department of Veterans Affairs reports that there are over 3.5 million World War II veterans still alive. They are reaching an age where long-term care is increasingly necessary. With Medicaid available only for nursing home care and limited home care, there are few options for paying home care or assisted-living care.
Only about 30% of our veterans who are eligible to receive assistance from the Veterans Administration (VA) actually receive VA assistance to pay for long-term care. This is because so many veterans and their widows or widowers are unaware of the benefits unavailable to them or they are under the belief that they do not qualify for VA benefits.
These benefits to pay for long-term care are different from disability compensation. Disability compensation is a more widely known benefit that pays money to veterans’ disability incurred while in the armed services. A surviving spouse death benefit is also a benefit that is based on the same principle.
The most often sought-after benefits to pay for long-term care of veterans are Housebound Benefits and Aid and Attendance benefits. These benefits are available to a veteran or his/her widow(er) and can help pay for the medical expenses of the veteran or his/her widow(er).
Housebound Benefits and the Aid and Attendance programs are available to the veteran and his/her spouse. However, there are eligibility requirements. The four criteria are:
The veteran must have served in the active service for at least 90 consecutive days with at least one day during wartime.
The veteran must have received a discharge other than dishonorable.
The veteran must have a permanent and total disability. A person 65 or older is deemed to have a total and permanent disability.
The veteran must have limited assets. If the assets of the veteran or the veteran and their spouse are greater than $80,000 (and sometimes even less), the excess assets may be transferred to reduce the amount of assets to the limit. The residence does not count as an asset for eligibility purposes. Also, unlike Medicaid rules, Veterans Benefits rules do not give the VA a claim or lien against the residence.
The amount of the benefit is the difference between a veteran’s unreimbursed medical expenses and his/her income. There is a reduction of the unreimbursed medical expenses allowed by an amount equal to five percent (5%) of the maximum benefit rate.
This maximum benefit rate is $1,950 per month for a veteran with dependents, $1,645 for a single veteran, and $1,057 for a widow(er). In determining the initial amount of the benefit, only unreimbursed medical expenses paid by the Veteran, his/her spouse, or dependent can be deducted.
Unreimbursed medical expenses include:
Home care costs
Assisted living costs
Nursing home costs
Recurrent medical supplies and services, only if paid by the veteran or family member.
Medical expenses can also include caregiver services provided by family members as long as there is a written Caregiver Agreement in place prior to the commencement of services.
Housebound Benefits provide for payment of medical expenses relating to care in the home. This benefit is in addition to the other income of the veteran, their spouse or dependent.
Aid and Attendance Benefits pay for medical expenses whether incurred in the home, in an assisted-living facility, or in a nursing home.
Since the Aid and Attendance benefit is almost never enough to fully pay the nursing home bill, Medicaid may be needed for nursing home care. Transferring assets to reduce the assets below the VA limit can result in a person being ineligible for nursing home Medicaid benefits for months or even years. In addition, purchasing annuities to achieve Aid and Attendance eligibility can also make a person ineligible for Medicaid. This can occur because the VA treats annuities differently than does Medicaid.
Therefore, if a person who is applying for Veterans Benefits to pay for home care or assisted-living care wants to qualify for Medicaid so that Medicaid can pay for his/her nursing home expenses, it is extremely important that an attorney who is experienced in Medicaid and Veterans Benefits law be consulted before any assets are purchased or property is transferred to become eligible for Veterans Benefits.
As an experienced veterans benefits law attorney, Dennis Christensen is dedicated to making your future needs and goals a reality. For a consultation with Dennis’ firm, contact our law office today.
For more information and Frequently Asked Questions (FAQs) about veterans benefits, click here.
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