My mother has to have care 24 hours/day. Medicaid cannot cover all the hours needed. As the spouse of a war time veteran, my mother has been granted $1000/month to cover additional hours needed for aid and attendance. This money cannot be used for other purposes. My mother's "real" income is $423/month from SS and $238/month as a veteran's spouse. Can the aid and attendance money from the VA be counted by Medicaid as income? Cancelled checks paid to attendants will provide proof as to where the money allowed by the VA for aid and attendance was spent
You are absolutely correct that the Aid and Attendance benefit your mother receives is to assist her with “unreimbursed medical expenses” which may include the cost of home care delivered by professionals or others and is not considered income either by the IRS or Medicaid agencies.
The question above was with respect to qualifying for Medicaid which is governed by different rules and regulations than VA benefits.
Technically, the Aid and Attendance benefit consists of a “Basic” pension on top of which the “Aid and Attendance” is added. When it comes to meeting Medicaid’s income requirements the “Basic” portion, which is not deemed to be reimbursement for medical expenses, is counted as income. The portion deemed as “Aid and Attendance” is not.
Most states have Medicaid programs (called “waiver programs”) that may assist a beneficiary with long-term care at home. I would strongly urge you to contact the agency that handles Medicaid in your state or your local Area Agency on Aging to learn what may available to assist your mom.
She can receive both VA assistance and Medicaid benefits simultaneously. Whoever told you otherwise was mistaken.
Receiving misinformation from employees at government agencies is not all unusual, and this is not to denigrate the hard work and dedication of most. The fact is that the rules and regulations are complex and confusing. When there is doubt go up the managerial chain of the organization your dealing with or seek professional advice.
If I tried to apply for medicare with a VA reimbursement check, I was told she wouldnt qualify so I never tried. Should I? And if she were able to receive medicaid would they take her VA check and only give her $35 a month? I would love to know the answers , thank you. Btw, I take care of her in my home, severe dementia and wont use a nursing home ever.
It is important to keep in mind which agency is responsible for evaluating and determining eligibility and qualification requirements for each program.
When it comes to the Aid and Attendance Improved Pension the VA determines if the costs incurred by a care giver to the veteran are eligible expenses or not. Generally, the VA will accept as deductible expenses from gross income those of licensed agencies or registries as well as private individuals including family members living with the veteran as long as proper documentation is provided.
If the veteran qualifies for the benefit and then applies for Medicaid benefits the Medicaid agency will treat the VA benefit the same irrespective of who is delivering the care to the veteran. Quite simply, the Medicaid agency could care less who is delivering the care and it is, frankly, none of their business. The matter is between the veteran and the VA.
I am very surprised to hear of your experience. The treatment of the Housebound or Aid and Attendance portion of VA non-service connected pensions with regard to qualification for SSI related programs is found in Social Security regulations (https://secure.ssa.gov/poms.nsf/lnx/0500830308) and has been adopted by and applies to every state that I am familiar with.
I see that you are in Florida and since this is the state where I conduct the majority of my practice I can say without equivocation that neither the Housebound nor the Aid and Attendance portion of the VA Improved Pension is counted as income in determining Medicaid eligibility. (ACCESS Florida Policy Program Manual Sections 1840.0906 through 1840.0906.08)
In my experience a letter from the VA has never been required as the pension rates are published and the Department of Children and Families has direct computer access to the veteran’s benefit information.
Keep in mind we are talking about pension and NOT compensation which is indeed fully countable.
Now if the claimant is in a nursing home (as you state your father is) and receives Medicaid the VA pension benefit paid to the claimant will be reduced to $90 per month and will be deemed as an addition to his “Personal Needs Allowance” of $35 per month.
If your father’s Aid and Attendance benefit is being counted as income for Medicaid eligibility purposes there is something wrong and if this determination is causing him to not qualify for benefits you should request a review by the supervisor in the office that is handling his Medicaid application.
Technically, there are three levels of non-service connected pension available: Basic, Housebound, and Aid and Attendance with Aid and Attendance offering the highest potential benefit.
Because all benefits above Basic are granted based on “unreimbursed medical expenses” incurred by the claimant it is presumed by Medicaid that benefits received above Basic are going to cost of care and are, therefore, NOT countable as income for Medicaid eligibility purposes.
Thus the only portion of the Aid and Attendance benefit received that is countable as income by Medicaid is the “Basic” amount. For 2013 the Basic benefit for a surviving spouse is $695.
If this income puts the Medicaid beneficiary over the Medicaid “income cap” for eligibility (which it looks like it will not in this case) an “Irrevocable Qualified Income Trust” can be established to maintain eligibility