Who Qualifies for VA Benefits for Assisted Living?

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Assisted living costs have been rising for years, with the national median price now $4,995 per month. In fact, the average annual rate of increase has outstripped annual inflation rates. However, costs can vary greatly depending on state/city/zip code, the elderly person’s care needs and whether you’re looking for a budget-friendly facility or luxury style assisted living community.

If you’re looking into assisted living for someone, you’re probably wondering what options exist to help defray the cost.  If this person is a wartime veteran or surviving spouse, this article is for you.

Aid and Attendance Benefit:

This little-known Veterans Administration benefit can greatly help in offsetting assisted living costs.  As of 2024, the benefit rates are:

$2,727 a month for a married veteran = $32,729 annually.

$2,300 a month for a single veteran = $27,609 annually.

$1,478 for a surviving spouse = $17,743 annually.

Also, $3,649 for two married veterans, who both need care = $43,791 annually.

This monthly benefit is tax-free and direct deposited into the veteran’s or his spouse’s account to help reimburse the cost of care. 

This is the highest monetary level of VA pension benefits for a wartime veteran unless the veteran has a high disability rating from the VA due to a service-connected disability, disease, or injury.  And it’s the highest level of benefit for the surviving spouse unless her husband’s death was attributable to a service-related injury or illness, or he had a 100% VA disability rating. https://www.va.gov/disability/dependency-indemnity-compensation/

Who Qualifies

While below are primary eligibility qualifications, there are various ins and outs involved in qualifying for this benefit. Therefore, it’s best to get a free pre-qualification interview by one of our trained Benefit Consultants as your first step – see the end of this article.

Age:

A veteran applying for this benefit must generally be 65 or older. There is no age requirement for a surviving spouse.

Wartime Service:

The veteran must have served at least 90 days of active military duty, with at least 1 of those days during an eligible war period:

  • World War II – December 7, 1941 to December 31, 1946
  • Korean conflict – June 27, 1950 to January 31, 1955
  • Vietnam War era – August 5, 1964 to May 7, 1975 (or for those who physically served boots-on-the-ground in the Republic of Vietnam, the eligible period is from November 1, 1955 to May 7, 1975)
  • Gulf War – August 2, 1990 through a future date to be set by presidential proclamation or law (Persian Gulf War veterans must have served two years of active duty or the full period for which they were called for active duty, with some exceptions.)

The veteran must have received an honorable discharge or other than dishonorable.

Care Needs:

The veteran or their spouse needs assistance or attendance (meaning looking after) by another with two or more of the daily activities of living: mobility (the medical term for this is “transferring”), bathing, dressing, eating (cooking or meal preparations alone does not count), or toileting.  This could be standby assistance, such as in the case of a person who is a fall risk and requires someone to be on standby when they are bathing.  For dementia, prompting/direction/supervision factors in – let’s say the person forgets to eat or would just eat ice cream if no one was monitoring them.

Or the person needs another aspect of custodial care: specifically, the care facility provides supervision as the individual cannot live alone because he or she has a physical, mental, developmental, or cognitive disorder that requires care or assistance on a regular basis to protect the individual from hazards or dangerous incidents to their daily environment.

Surviving Spouse:

The surviving spouse must have been married to the veteran for at least a year, in addition to being married at the time of their death and never remarried. The only exception is if the spouse remarried to a non-wartime veteran or civilian between January 1, 1971, through November 1, 1990, and the marriage ended (divorce, death, annulment) during that same time period.

Financial Criteria:

To get the full benefit amount, the veteran or surviving spouse needs to be spending all of their monthly income paying for care, whether it be a care facility or caregivers. The cost of supplemental health insurance is included in the medical cost equation. However, it’s not all or nothing; it’s possible to get a partial benefit, depending on their income versus the cost of care.

Some people misunderstand that this benefit is strictly for low-income people. That’s not true. As an example, a person with a $6,000 monthly gross income who is paying $5,700 for assisted living, could still get the benefit – assuming all other requirements are met.

In other words, the cost of care is subtracted from monthly income in calculating income in terms of this benefit.

The net worth limit for 2024 is $155,355. This includes checking, savings, stocks, CDs, annuities, and other financial assets. One’s house and up to 2 acres, as well a vehicle, are exempt. 

For a married veteran, both the veteran’s and his wife’s assets are counted in the net worth calculation.

The VA has a three-year look-back rule on using gifting or transferring assets as a means to reduce net worth. There are certain allowable spend-down options for those who are marginally over the asset threshold, such as pre-paying for a burial policy, though it’s best to get expert advice on this.

Home Care, Board and Care Homes, Day Care

The Aid & Attendance Benefit is not exclusive to assisted living. The benefit can apply to home care situations, group care homes (also called residential care homes or adult family care homes), elderly day care centers and other types of senior living facilities depending on how they are structured.

Don’t Get Lost in Red Tape

Like so many government programs, the Aid & Attendance Benefit qualification and application process is complex. Not every nuance of the VA rules is listed here. The VA forms do not explain how to get approved or how to maximize the benefit amount. Without expert guidance it is easy to fall into pitfalls, lengthy delays and end up with a denial. If you or a loved one is in assisted living or will be transitioning to a care facility or requires caregivers, contact one of our experienced Benefit Consultants today at 877-427-8065 or click here to find out more about this benefit and how to qualify.

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