There may come a time when a senior veteran needs daily help with personal care, either at home or in an assisted living facility. VA Aid and Attendance and Medicaid are two ways of funding the care that may be needed.
Aid and Attendance
Aid and Attendance is a Veterans Administration monthly monetary benefit for wartime veterans and their spouses. It is a tax-free enhanced pension that does not need to be paid back.
The benefit can help cover the cost of home care, adult day care, board and care, assisted living, and skilled nursing facility care. Home care can be provided by a family member (excluding a spouse), friend or professional caregiver. You do not have to be licensed to provide the care.
Minimally, the veteran must be at least 65 years of age or older or, if younger, must have a permanent and total disability, or is a long-term care patient in a nursing home or receiving SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income). Spouses of veterans can qualify for the benefit at any age.
The veteran must also have served during wartime (at least 90 days of active duty and at least 1 day during an eligible period of war) and received an honorable or anything other than dishonorable discharge.
A common misconception regarding military requirements is that the veteran must have served in a combat zone or must be receiving VA disability due to a wartime injury or illness (service-connected).
To qualify for Aid and Attendance, the claimant (person applying for the benefit) must need help with some of the activities of daily living such as bathing, dressing and mobility. There are also income and asset requirements.
The maximum benefit amount for a single veteran is $2,229 per month. For a married veteran the maximum benefit amount is $2,642 per month and for a surviving spouse it’s $1,432.
The surviving spouse of a veteran must have been married to the veteran for at least one year before they passed. There is also a special second marriage rules which states that a spouse who remarried may still be able to qualify for the benefit if they remarried and divorced their second spouse or the second spouse died between January 1st, 1971, and November 1, 1990.
Not many people know about the Aid and Attendance benefit, even though it can save a veteran or spouse tens of thousands of dollars a year in caregiving expenses.
Applying for the benefit can also be difficult due to the complexity of the paperwork. Many people end up turning in incomplete claims which can take longer to process.
To find out more about the VA Aid and Attendance benefit, contact one of our consultants today at 877-427-8065 or click here.
Medicaid
Medicaid is a jointly funded federal and state health insurance program for people with limited income and resources, individuals with certain disabilities, pregnant women, children, and seniors. It is often confused with Medicare, a federal health insurance program for people over 65 years of age.
Under Medicaid federal guidelines, each state must provide nursing facility care and home care for individuals that meet the program’s requirements.
The state has some flexibility in deciding how various aspects of the program will be implemented. States can also waive some rules (Medicaid Waivers) in order to provide services to specific groups of people with certain health conditions.
There are many different types of waivers. Home and Community-based Waivers (HCBS) are designed to provide the care and assistance someone may need to stay at home longer instead of transitioning to a care facility. The assistance includes occupational, speech and physical therapy, personal care assistance, adult day care and respite care.
There are also waivers to pay for home and vehicle modifications, medical equipment, meal delivery and emergency transportation.
Sometimes Medicaid can help cover the cost of assisted living. Medicaid is also used to pay for skilled nursing facility care.
You can find a list of each State’s Medicaid waivers here:
The asset requirements for Medicaid are usually very strict. In most cases an applicant cannot have more than $2,000 in assets. When the person applying for the assistance is married, the assets of both the applicant and his or her spouse are considered jointly owned. But the spouse of the person applying for Medicaid long-term care may be able to keep up to around $137,000 instead of spending the assets down. Countable assets include checking and savings accounts, money market, certificates of deposit, mutual funds, stocks, bonds and any second properties like homes and land.
Medicaid wavier programs are often very confusing. And unlike the VA Aid and Attendance benefit, the rules can vary from state to state.
A key difference between the two programs is that Aid and Attendance can help a veteran or spouse remain private pay. Remember that Medicaid is a type of insurance for individuals who can’t afford the care they need. When you are paying for care out of pocket, you generally have more control over the type and quality of care that is being provided, starting with the fact that you can choose what facility you want to move to. More than half the country’s assisted living facilities do not accept Medicaid insurance.
About Medicare
Medicare is a fee-based health insurance program for people age 65 or older and, in some situations, for people under the age of 65 with certain types of disabilities or health conditions. It was started in 1965 under the Social Security Administration. Currently it is managed by the Centers for Medicare and Medicaid Services.
The are four parts to Medicare:
- Part A – inpatient care in a hospital, skilled nursing facility care, nursing home care, hospice care and home health care. A doctor or other allowable practitioner can order home health care if it is medically necessary, and the care is needed on a very limited basis.
- Part B – medical insurance
- Part C – private insurance options to help pay for hospital and medical costs.
- Pard D – helps pay for prescription and medications.
Medicare does not pay for long-term care, also called custodial care.
