For veterans or their surviving spouses who need long-term care services such as in-home care or nursing home care, there may be help available. Surprisingly, only 5% of long-term care benefits are applied to because most people don’t know about these programs.
Here are some tips to help veterans and their families get the care they need when they need it.
Qualifying for Veterans Affairs Long Term Care Programs
Since implementing new rules in October 2018, the Department of Veterans Affairs (VA) has made it more difficult for vets to qualify for long-term care benefits. The rules established an asset limit, a look-back period, and asset transfer penalties for claimants applying for VA pension benefits.
The VA has an underused pension benefit called Aid and Attendance (or A&A benefit) that provides tax-free money to those who need assistance performing everyday tasks like dressing or bathing. Aid and Attendance provides money to those who need assistance such as in-home care, board, and care, an assisted living facility or a private-pay nursing home. Unfortunately, many people who could qualify for this level of help aren’t aware that it exists.
Who is Qualified for Long-Term Care?
Wondering if you or a loved one is eligible for the VA’s long-term care programs? Here’s a quick rundown of what it takes to qualify.
- Military Service
Aid and Attendance is a pension benefit, which means it is available to veterans who served at least 90 days, with at least one day during wartime. He or she must have had an honorary discharge. Even veterans whose income is above the legal limit for a VA pension may qualify for the Aid and Attendance benefit if they have large medical expenses for which they do not receive reimbursement.
- Financial Need
Financial need must be established. To qualify for Aid and Attendance, a veteran (or the veteran’s surviving spouse) must meet certain income and asset limits. Assets must be less than $80,000.
- Medical Assistance Needs
In order to qualify, the veteran or spouse must need personal care assistance with eating, bathing, or dressing. The veteran does not have to have a service-connected disability to qualify.
Asset Limits & Net Worth
In the past, you could transfer assets over the VA’s limit before applying for benefits and the transfers would not affect eligibility. However, this is no longer the case.
To qualify a veteran (or spouse) must have a net worth limit of $127,061, which will increase each year with cost-of-living adjustments.
An applicant’s house (up to a two-acre lot) does not count as an asset even if the applicant is currently living in a nursing home. Applicants are also able to deduct from their income, medical expenses.
This can include Medicare, Medigap, and long-term care insurance premiums; over-the-counter medications taken at a doctor’s recommendation; long-term care costs (such as nursing home fees); the cost of an in-home attendant providing medical or nursing services; and the cost of an assisted living facility. These expenses must be non-reimbursed.
In other words, insurance must not pay these medical expenses. These expenses should also be recurring, meaning they recur every month.
What About Surviving Spouses?
The new regulations set a net worth limit of $123,600, which is the current maximum amount of assets that a Medicaid applicant’s spouse is allowed to retain. But in the case of the VA, this number will include both the applicant’s assets and income. It will be indexed to inflation in the same way that Social Security increases.
Veterans or surviving spouses are eligible if they require the aid of another person to perform an everyday action, such as bathing, feeding, dressing, or going to the bathroom. This includes individuals who are bedridden, blind, or residing in a nursing home.
The Look-Back Period
The regulations also establish a three-year look-back provision. Applicants will have to disclose all financial transactions they were involved in for three years before the application in order to determine if the veteran transferred assets in order to qualify for benefits.
Penalty Periods
Applicants who transferred assets to put themselves below the net worth limit within three years of applying for benefits will be subject to a penalty period that can last as long as five years. This penalty is a period of time during which the person who transferred assets is not eligible for VA benefits.
the VA will determine a penalty period in months by dividing the amount transferred that would have put the applicant over the net worth limit by the maximum annual pension rate (MAPR) for a veteran with one dependent in need of aid and attendance.
For example, assume the net worth limit is $123,600 and an applicant has a net worth of $115,000. The applicant transferred $30,000 to a friend during the look-back period. If the applicant had not transferred the $30,000, his net worth would have been $145,000, which exceeds the net worth limit by $21,400.
The penalty period will be calculated based on $21,400, the amount the applicant transferred that put his assets over the net worth limit (145,000-123,600).
How Do You Apply?
If you would like to apply for VA health benefits, visit VA Geriatrics and Extended Care.
It can take six to eight months, on average to get approved. Some applicants wait more than a year. However, once the application is approved, benefits are applied retroactively to the date of application.
You can find more information about how to apply for VA long-term care services on the U.S. Department of Veterans Affairs website.
If you’re not currently in the VA health care program, you can apply for benefits now.
Contact a VA office if you have questions. To find out how to access these services, contact your VA social worker. Or, call our toll-free hotline at 877-222-8387.
Consider a trust sooner rather than later.
A revocable living trust places your assets into a trust that can be used to your benefit during your lifetime. After your death, these assets are transferred to your beneficiaries.
Unlike a will, a living trust eliminates the necessity for probate.
We have the knowledge and experience required to answer your questions.
Let’s Talk About VA Planning
Port Legal is here to help you with your VA planning needs. Our goal is for all wartime veterans and their spouses to find the financial assistance from the Veterans Aid & Attendance Pensions Benefit program they need to feel safe and well cared for in their later years.
We can help you review your assets with the three-year look-back period in mind.
At Port Legal, we want to help you access the benefits you deserve for serving your country. Our blog offers a step-by-step guide “Veterans’ Guide to Long Term Care” to help you navigate the process of applying for VA health care benefits.
Veterans or their spouses who think they may be affected by the new rules should contact an attorney immediately. Contact us for a consultation and speak an attorney for free.
