Basics of VA Aid and Attendance to Help Pay for Costs of Long-Term Care

If you served during active duty during a wartime period (WWII, Korean War, Vietnam War or Persian Gulf War) or if you are the widow of a wartime veteran, you may be eligible for a monthly check from the VA. This program is known as “VA Aid and Attendance.” In many cases you could receive $1000 or $2000 per month or more for services you (or your spouse) performed for our country many years (even decades) ago.

What follows below is complicated. And it’s important.  The VA benefits system is a “maze” and the best way through is by getting help from someone who has been there before.

Long-term care benefits for veterans and surviving spouses

You already know that long-term care costs can add up quickly. You may also have heard about a program from the Veterans Administration (VA) called Aid and Attendance, which provides money to those who need assistance performing everyday tasks. If you’re incurring costs for in-home care or for assisted living or nursing home costs, you likely can qualify depending on your overall assets. Here’s more about aid and attendance.

This benefit requires that you, or your deceases spouse, served our country on active duty in the military at least 90 days, with at least one day during wartime. No service-related disability is needed to qualify (service connected disability may qualify the veteran for a different program, called “service connected compensation.”)  Non-service connected disabilities, such as various memory or mobility issues, could qualify a veterans or surviving spouse if they require the aid of another person to perform an everyday action, such as bathing, feeding, dressing, or going to the bathroom. That’s why it’s so important to someone who is bedridden, blind, or residing in a care community (assisted living or nursing home).

Requirements for qualifying for benefits

To qualify the veteran or spouse must have less than $80,000 in assets, excluding the home and vehicle. (NOTE: the asset limitations are likely to change soon under new rules proposed by the VA in 2015.)

If eligible because countable assets are below the cut-off amount, the applicant’s income will determine what, if anything, the VA will pay. To receive Aid and Attendance,  the net monthly income (of the applicant or couple) must be less than the Maximum Annual Pension Rate (MAPR). Following are the amount for MAPR for 2015 for the Aid and Attendance level of VA pension, depending on the applicant’s marital status:

Single veteran $21,466
Veteran with one dependent $25,448
Single surviving spouse $13,794
Surviving spouse with one dependent $16,456

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. These expenses could include Medicare, supplemental health care insurance premiums (Medigap insurance), and long-term care insurance premiums; prescriptions and over-the-counter medications regularly taken at a doctor’s recommendation; long-term care costs, such as the monthly cost of assisted living or nursing homes; and the cost of in-home care for some medical or nursing services. These expenses must be not be reimbursed by insurance; that means only deductibles or co-pays or items not eligible for Medicare (such as home-care, assisted living, and nursing home costs) would be deductible. Expenses also should be recurring each month.

Presuming that you qualify with assets below the allowed amount, the amount of pension you could receive depends on your net income. The VA pays the difference between your income (including both spouse’s income) and the allowed MAPR.

Example. Tony, a single veteran, has income from Social Security of $18,500 a year and a pension of $14,000 a year, so his total income is $32,500 a year. He pays $22,000 a year for home health care, $1,122 a year for Medicare, and $1,992 a year for supplemental insurance, so his total medical expenses are $25,114. Subtracting his medical expenses from his income ($32,500 – $25,114), Tony’s countable income is $7,386. Tony could qualify for no more than $14.080 ($21,466 – $7,386) in Aid and Attendance benefits. NOTE: if Tony was spending all of his monthly income and more on his care costs, then he could qualify for the full pension available, which would be $21,466 per year.

If you don’t have a home, and your assets are well under the permitted maximums, you may want to contact the North Carolina Veterans office. There is at least one office in every county in the state. You can find office locations here.

More information if available through the VA’s guide to long-term care available online.