VA Benefit Assisted Living Costs

VA Benefits May Cover the Cost of an Assisted Living Facility or In Home Care

As we discussed in previous Elder Law Today newsletters (here and here), the Veteran’s Administration provides a wonderful pension benefit for those individuals who served at least one day during a period of wartime and are now disabled due to non-service connected reasons (aging related issues, Alzheimer’s, Parkinson’s, multiple sclerosis, and/or other physical disabilities). This pension, referred to as “Aid and Attendance Allowance”, may pay the long term care provided in an assisted living facility, or in-home care.

The “Aid and Attendance” (A and A) benefit is available to a veteran who is disabled and requires the aid of another person to perform the personal functions required in everyday living. A veteran can show they are eligible if they have a substantial need for assistance with the activities of daily living. Such activities include bathing, dressing, meal preparation, etc. A veteran would also qualify for this pension if they can show they need the attendance of another person in order to avoid the hazards of his or her daily environment. The need for assistance does not have to be permanent.

Under this program, a veteran can receive a maximum of $1,801.00 per month in benefits and a widow or widower can receive up to $976.00 as a maximum benefit for aid and attendance for the year 2007. The applicant must be “permanently and totally disabled” under the VA rules.

The vet does not need to be helpless under the rules. He only needs to show that he is in need of aid and attendance on a regular basis. Someone who is housebound or in an assisted living facility and over the age of 65 is presumed by the Veterans Administration to be in need of Aid and Attendance.

Eligibility for the program is based on the income and assets of the veteran. In determining income, deductions are allowed for unreimbursed medical expenses (UMEs). In home care workers are an allowable deduction, provided that some medical or nursing services are provided. Also, the cost of an assisted living facility can be an allowable medical deduction against gross income.

In addition, a family member can provide in-home care for a veteran who is applying for aid and attendance. In order to meet the disability criteria, the care services provided by an unlicensed relative must be prescribed by a health care professional (ex. doctor, RN, LPN or licensed physical therapist) and the professional must consult with the unlicensed relative caregiver at least once a month (in person or by telephone) to monitor the regimen. In addition, there must be a valid care contract in place and the caregiver must be receiving no more than fair market value for services he or she is providing.

If you or someone you know is a Veteran receiving care in an assisted living facility, or at home, please encourage them to file a claim for this benefit. It would be prudent to seek the guidance of an experiended elder law attorney who is fimilar with this veteran’s benefit.

The following are some additional requirements for eligibility:

a. Be a veteran who served at least 90 days of active duty.

b. At least one day of active duty had to be during wartime: WWII – 12/7/41 to 7/25/47 – Korea – 6/27/50 to 12/31/55 – Vietnam – 8/5/64 to 5/7/75;

c. Does not need to have been in combat;

d. Discharged other than dishonorably

e. Income less than $1,800 per month, once out-of-pocket medical expenses are considered.

f. Net worth less than approximately $50,000 for singles or $80,000 for couples.

g. Gifting of assets is allowed with no look-back period, but must be coordinated with Medi-Cal planning and gifting, which does have a look-back period.

 

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