Navigating long-term veterans care benefits

Navigating long-term veterans care benefits


Long-term care costs can add up quickly. For veterans and the surviving spouses of veterans who need in-home care or are in a nursing home, help may be available. The Veterans Administration (VA) has a pension benefit called Aid and Attendance that provides money to those who need assistance performing everyday tasks. Even veterans whose income is above the legal limit for a VA pension may qualify for the Aid and Attendance benefit if they have large medical expenses for which they do not receive reimbursement.
Aid and Attendance is a pension benefit, which means it is available to veterans who served at least 90 days, with at least one day during wartime. The veteran does need to have service-related disabilities to qualify. Veterans or surviving spouses are eligible if they require the aid of another person to perform an everyday action, such as bathing, feeding, dressing, or going to the bathroom. This includes individuals who are bedridden, blind, or residing in a nursing home.
To qualify the veteran or spouse generally must have less than $80,000 in assets, excluding the home and vehicle. In addition, the veteran’s income must be less than the Maximum Annual Pension Rate (MAPR). Following are the MAPRs for 2014:
Single veteran — $21,107
Veteran with one dependent — $25,022
Single surviving spouse — $13,562
Surviving spouse with one dependent — $16,179

Income does not include welfare benefits or Supplemental Security Income. It also does not include unreimbursed medical expenses actually paid by the veteran or a member of his or her family. This can include Medicare, Medigap, and long-term care insurance premiums; over-the-counter medications taken at a doctor’s recommendation; long-term care costs, such as nursing home fees; the cost of an in-home attendant that provides some medical or nursing services; and the cost of an assisted living facility. These expenses must be unreimbursed (in other words, insurance must not pay the expenses.) The expenses should also be recurring, meaning that they should recur every month.

How it works

The amount a person receives depends on his or her income. The VA pays the difference between the veteran’s income and the MAPR. If, for example, John, a single veteran, has income from Social Security of $16,500 a year and a pension of $12,000 a year, his total income is $28,500 a year. If he pays $20,000 a year for home health care, $1,122 a year for Medicare, and $1,788 a year for supplemental insurance, so his total medical expenses are $22,910. Subtracting his medical expenses from his income ($28,500 – $22,910), John’s countable income is $5,590. John could qualify for $15,517 ($21,107 – $5,590) in Aid and Attendance benefits. For 2014, the most a single veteran can receive is the same as the MAPR which is $1,759/month, for a married veteran, $2,085/month and for the surviving spouse of a veteran, $1,130/month.
One issue is that the Veteran’s Administration generally does not act on Aid and Attendance applications quickly. I have had applications approved in as little as 2 months and as long as 24 months, perhaps longer if the veteran or spouse has dementia and needs a third party to receive the funds. However, once approved, the benefits will be paid retroactive to the application date. Unfortunately, if the veteran dies without a spouse or dependent before the benefits are received, any retroactive benefit will be lost.
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Attorney Macrina G. Hjerpe is a partner in the Providence law firm Chace Ruttenberg & Freedman. She practices in the areas of Estate Planning, Probate, Estate Administration, Trust Administration, Trust Litigation, Guardianship, Business Succession Planning, Asset Protection Planning, Elder Law and Estate Litigation.