Veterans' Benefits for Home and Assisted Living Care

By William S. Fralin, Esq.

The Estate Planning and Elder Law Firm, PC

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Veterans' Benefits for Home and Assisted Living Care

One little-known benefit for veterans and their families is the Aid and Attendance (A&A) benefit. This benefit can be used for care in an assisted living facility or for care at home
Title 38 of the U.S. Code contains statutes regulating veterans benefit programs. Many of you may be familiar with service-connected Veterans Compensation. This compensation is provided to veterans for disabilities caused or exacerbated by military service, and it is normally expressed as compensation for a certain percentage disability.
Non-service connected benefits (pensions) are available to veterans (and some widows or widowers) who meet certain conditions. The veterans do not have to be retired from military service, but the program is needs-based. The veteran must have served 90 days on active duty (the requirement is longer for more recent veterans), with at least one day during wartime, and have received a discharge under conditions other than dishonorable. The veteran must be “permanently and totally disabled” because of a non-service connected condition, or be over the age of 65 years. Additionally, for the improved pension program, the veterans income cannot exceed $931 per month with no dependents or $1,220 per month with one dependent), the current maximum annual pension rate (MAPR).
The A&A benefit is an increased benefit for veterans who require “care or assistance on a regular basis” to protect them from dangers in their daily living environment. Veterans living in assisted living facilities are presumed to need this level of assistance, but the veteran should include a letter from the veterans personal physician regarding the veterans disability.
The need for A&A increases the income limit from $931 per month to $1,554 per month with no dependents, and from $1,220 per month to $1,842 per month with one dependent. The MAPR for the A&A benefit, therefore, is the higher of $1,554 or $1,842 per month. Widows or widowers can receive a maximum of $998 per month.
One significant feature of the
pension program is that income is reduced by paid but un-reimbursed
medical expenses, including insurance premiums, Medicare premiums,
prescriptions, dental and vision care, and the costs of an assisted living facility, in-home aid, or adult day care. In many cases, these costs can easily reduce the applicants income to a level that would permit the applicant to receive the benefit. The net worth of the applicant is also considered in the evaluation for A&A. There are no hard and fast rules, but a net worth below $80,000 for a couple, or $50,000 for an individual, has been acceptable.
The VA looks to the net worth at the time of the application. Also, there is no penalty period for the transfer of assets. If the veteran, however, transferred property that produced a great deal of income on the previous years tax return, that previous years higher income would be reflected on the application and may affect eligibility. Further, because the lack of a penalty for transferring asset conflicts with Medicaid requirements, elder law attorneys should advise their clients of this disconnect and plan accordingly. The A&A benefit payments are made directly to the veteran or eligible surviving spouse, and they are specifically excluded from the definition of income for Medicaid purposes. The benefit is reduced to $90 per month if the veteran lives in a nursing home.
Planning for long term care needs is often an emotional and difficult subject. Be sure that your advisor can assist you with all your needs, including a thorough review of the benefits for which you may be eligible.