Veterans Administration Benefits for Long Term Care

Many wartime veterans and their surviving spouses are now spending significant amounts of money on their medical needs, and are also facing long-term care expenses or will need some type of long-term care in the near future. The Veterans Administration has funds that are available to help pay for Medical expenses and Long Term Care, but many families do not know that these benefits exist.

There are benefits known as Improved Pension or sometimes known as Aid and Attendance Benefits that can pay the for the medical needs of a veteran or surviving spouse who requires assistance in activities of daily living (dressing, undressing, eating, toileting, etc.), is blind, or is a patient in a nursing home. Assisted care in an assisted living facility also qualifies.

The Improved Pension benefit known as a Housebound Allowance is for those who need regular assistance but would not meet the more stringent requirements for Aid and Attendance, and wish to remain in their own home or the home of a family member. Care can be provided by family members or outside caregiver agencies.

The Basic Pension level is for veterans and surviving spouses who are 65 years old or older or who are 100% disabled, and who have limited income and assets.

What are the Qualifications to receive Benefits?

A veteran is not required to have service-related injuries to qualify for these pension benefits, but must meet certain wartime service and discharge requirements. A surviving spouse must also meet marriage requirements to the qualified veteran. There are additional requirements that must be met for a disability claim if the claimant (the veteran or surviving spouse filing for benefits) is under 65 years old.

When determining eligibility, the VA looks at a claimant’s total net worth, life expectancy, income and medical expenses. A married veteran and spouse should have no more than $80,000 in “countable assets,” which includes retirement assets but does not include a home and vehicle. This amount is a guideline and not a rule.

Income for VA Purposes (called IVAP) must be less than the benefit for which the claimant is applying. IVAP is calculated by subtracting “countable medical expenses” (recurring out-of-pocket medical expenses that can be expected to continue through the claimant’s lifetime) from the claimant’s gross income from all sources.

Note: It is possible to reduce assets and income to a level that will be acceptable to the VA. For example, excess liquid assets (such as cash or stocks) could be converted to an income stream through the use of an annuity or promissory note. Beware however, that many circumstances may be handled without an annuity. Also keep in mind that many annuities are NOT designed with VA benefits or Medicaid benefits in mind.

In addition, because the claimant may need to qualify for Medicaid in the future, it is very important that any restructuring or gifting of assets be done in ways that do not jeopardize or delay Medicaid benefits. Consult a board certified Elder Law Attorney for legal advice especially when it comes to the Medicaid rules in the state where the long term care will be provided.

Applying for Benefits

The VA often takes more than a year to make a decision, but once approved, benefits are paid retroactively to the month after the application is submitted. Having proper documentation (discharge papers, medical evidence, proof of medical expenses, death certificate, marriage certificate, financial information, and a properly completed application) at the time the application is submitted can allow the application to be approved more quickly. When a veteran is approved he or she can receive additional benefits such as no cost prescriptions through a VA medical center.

Because time is critical for these aging veterans and their surviving spouses, application should be made as soon as possible. For more information, visit http://www.va.gov or in states such as North Carolina that provide local veterans service office, contact the local office for an appointment. However, plan ahead before going to the service office, because the service office will not help you plan ahead. They take you as you are when you walk in. For pre-planning contact Larry Hartley before you go to the service office.