Veterans’ Benefits for Home and Assisted Living Care

April 25, 2008
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Oast & Hook is dedicated to finding additional ways to help seniors defray the costs of long-term 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. Oast & Hook is pleased to add veterans’ benefits planning as a new practice area.
Title 38 of the U.S. Code contains statutes regulating veterans’ benefit programs. Many of our readers are probably 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 veteran’s 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 veteran’s personal physician regarding the veteran’s 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 unreimbursed 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 applicant’s 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; but there are no hard and fast rules. The VA looks to the net worth at the time of the application; 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 year’s tax return, that previous year’s 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.
Oast & Hook can assist clients with their long-term care planning needs, whether the client lives at home, in an assisted living facility, or in a nursing home. This includes a thorough review of the benefits for which the client is eligible, including the Aid and Attendance benefit, as well as the planning necessary for eligibility for these benefits.
For further information on this topic, please visit the following Web sites:
Department of Veterans Affairs: www.va.gov
Commonwealth of Virginia Department of Veteran’s Services: www.vdva.vipnet.org
Federal Benefit Manual: www1.va.gov/pubaff/fedben/Fedben.pdf

Ask Allie

Kit Kat: Allie, many senior citizens desire to continue to work to earn additional income and stay busy. Do you have any suggestions?
Allie: Kit Kat, thank you for writing. Yes, the financial planners at Oast & Hook tell me that many senior citizens continue to work in order to stay busy and to offset the toll of inflation and the high costs of health care. I do have a suggestion. Pet-sitting companies will hire seniors. This work provides an income source in addition to exercise and companionship. For more information about pet sitting, seniors can visit www.petsitters.org.
Please feel free to e-mail your pet and animal-related questions to Allie at:allie@oasthook.com .

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