VA Benefits & Nursing Home Medicaid
You may recall from our previous blog Medicaid Eligibility and Asset Transfer that qualifying for Medicaid can sometimes be tedious. In many situations, a person has too many assets to qualify. This can get even more complicated when Veterans Affairs (VA) benefits are a factor.
It is extremely important to understand the income and asset limits when applying for either Nursing Home Medicaid or a Veteran’s pension as well as making sure qualifying for one will not disqualify you for the other.
What VA Benefits Are Available?
If a veteran is eligible for a VA Pension but may require the “aid and attendance” of someone else to perform the tasks of daily living, or if the veteran is housebound, he may be eligible for additional income for this purpose.
The Aid and Attendance pension can be received as additional income if a veteran meets one of the following criteria:
- He requires the aid of someone else in order to perform personal functions of everyday living (bathing, feeding, dressing, going to the restroom, etc.).
- He is bedridden.
- He is a patient in a nursing facility because of a mental or physical incapacity.
- He is legally blind or worse.
A housebound pension is available if the veteran is substantially confined to his immediate premises because of permanent disability.
Can You Qualify for Both Nursing Home Medicaid and VA Pension?
Generally speaking, a person can be eligible for Medicaid and a Veteran’s pension (Aid and Attendance or Homebound Benefits) at the same time. Realistically, however, individuals only receive benefits from one program at a time.
The biggest factors to consider when deciding which program would be most beneficial to the recipient are the marital status of the individual and what type of care is needed. If an individual applying for benefits is married, it is possible for him to qualify and use Medicaid benefits to pay for his care, while qualifying for an Aid and Attendance pension that is used to benefit his spouse. If he is single, however, it is less likely to be beneficial to receive both.
In practice, Medicaid tends to provide better for the individuals who need the care offered at a nursing home, while an Aid and Attendance pension can provide better assistance to someone who only needs in-home care, or to be in an assisted living facility. Unfortunately, the difference in cost for a nursing home, and a beneficiary’s income can be so large that the pension will not cover it. In this instance, Medicaid is the better option as it will cover the total difference between the cost of care and the person’s income.
When is VA Pension the Best Option?
Being Medicaid eligible can create difficulty for those who are also receiving a VA Pension while living in a nursing home. For a single individual, the VA will refuse to pay the full benefit owed if that person is also eligible for Medicaid. VA will only pay $90 in Pension benefits towards the individual’s nursing home care.
However, if a patient must spend down assets to become Medicaid eligible or if they are forced to private pay at a nursing home, the VA Pension would most likely be the best option. In this instance, it is imperative to discuss your options with a licensed practitioner who can help guide you to the best option based on your circumstances.
What if Care is Needed Immediately?
The final and possibly largest factor for an individual to consider is how quickly care is needed. While the VA Pension benefit is much easier to apply for, the application itself can take 6-12 months to get approved (if not longer) and the applicant will wait until approval to begin receiving any benefits. The Medicaid applicant will spend a much more extensive amount of time on the application but can usually begin receiving benefits within 2-3 months.
If the individual cannot afford to self-pay for any portion of their nursing home, or in-home care, Medicaid will most likely be the best option as approval is much quicker, leading to quicker receipt of benefits.
What Do I Do Next?
As always, check with your estate management professionals. Make sure they are well qualified in both Medicaid planning as well as VA Pension benefits and how those two can comingle. Depending on your circumstances, one or both, may be right for you.
Finally, do not wait to start planning until you need the benefits. Planning ahead will get you the most benefit out of all your benefits.
Matthew Harris Law, PLLC – Estate Management Division
1001 Main Street, Suite 200, Lubbock, Texas, 79401-3309
Tel: (806) 702-4852 | Fax: (800) 985-9479