Mon, 16 November 2009
Understanding the maze of laws and benefits that form our long term care system is a full time job. That’s why I devoted my practice exclusively to elder and disability planning. A few weeks ago I was reminded of that fact when I was asked what I know about a particular VA program that provides adult day care services for a small co-pay. This clearly didn’t sound like the Aid and Attendance program that in the past two years we have incorporated into our planning arsenal.(see my 2/25/08 post). So I decided to investigate and here’s what I learned.
The VA doesn’t do a good job of publicizing its benefits and services so getting accurate information is never easy. There is a program of services under what the VA calls the Geriatric and Extended Care Program. These include programs that provide care in a veteran’s home or in a community setting such as adult day care, specialized services for rehabilitation following, amputation, stroke, traumatic brain injury and spinal cord injury, physical therapy and home hospice care. Keep in mind that the range of services can vary greatly depending on where you live and which health care network the VA has charged with providing those services.
Uncovering and understanding the eligibility requirements is the harder part. Unlike the Aid and Attendance program which is available to veterans and their spouses, the Extended Care Program is only available to veterans who received a discharge under honorable conditions. It is, however, not limited to veterans who served during wartime (again, unlike Aid and Attendance). There is no length of service requirement for vets who enlisted before 1980.
There is a co-pay requirement applicable to the nonservice connected veteran, that is, a veteran who’s injury or illness is not linked to his military service (which is the case with most of our elderly clients). In order to be eligible the veteran’s income must not exceed the maximum annual pension rate for the Aid and Attendance program. The co-pay generally ranges from $5 to $97 per day, depending on the particular service received.
What I concluded from my research so far is that the Extended Care Program is another option, another piece of the long term care puzzle. And with proper guidance our clients may be able to tap into a valuable source which will help lessen the risk that they will run out of money and options when they reach the next step in the long term care journey.
Category:Veteran's Benefits -- posted at: 6:00am EDT
Mon, 25 February 2008
The discussion of long term care and government benefits to pay for that care most often leads to the topic of Medicaid, however, there is another benefit available to qualified veterans of the U.S. military through the Veterans Administration that can be a source of funds to pay for assisted living and home based care. Eligible veterans and their widowed spouses may be eligible for a non-service connected pension, as much as $1801 per month for veterans, $976 per month for widowed spouses. The program is commonly known as the Aid and Attendance program and the applicant must be deemed permanently and totally disabled. But if you're thinking that it's probably too hard to prove a disability that's not necessary the case. The VA presumes that someone over 65 years of age and housebound or in an assisted living facility is permanently and totally disabled.
As is often the case with government benefits, the rules can be confusing. Similar to the Medicaid program applicants must meet certain income and asset limits. The pension amount is determined by a specific formula. Unreimbursed medical expenses are subtracted from gross income. That number is then subtracted from the maximum pension amount to determine the applicant's pension amount. It is important to understand that the cost of the assisted living facility and home health aides is usually counted as an unreimbursed medical expense. In many cases, it becomes easy to qualify for the maximum pension amount.
There is also an asset limit, approximately $40,000 for a single individual, $80,000 for married couples. Unlike the Medicaid program, however, there is no lookback period or penalty for transferring assets. This means that one can transfer assets to get below the asset limits and immediately qualify for Aid and Attendance.
However, things are not that simple. (They rarely are when it comes to the long term care system and government benefits). Transferring assets can result in additional benefits from the VA but those same transfers will result in ineligibility for Medicaid. Now, that's not to say that one should forget about Aid and Attendance. It does, however, require a carefully drafted plan so that should the applicant need the next level of care down the road (ie. nursing home care) the applicant will be able to qualify.
Consulting with a knowledgeable elder law attorney who will help a family plan for the next level of care, not just the care that is needed now, is advisable.
Category:Veteran's Benefits -- posted at: 8:00am EDT