Veterans and Surviving Spouses Who Need Long-Term Care Can Get Assistance with Costs from the VA

This Veterans Day, make sure you are taking advantage of all the services available to you. If you are a veteran or the surviving spouse of a veteran who is facing expensive long-term care costs, either in a nursing home or at home, there may be a way to get help.

The Veterans Administration (VA) has an underused pension benefit called Aid and Attendance that provides money to those who need assistance performing everyday tasks. 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.

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. The veteran does not have to have service-related disabilities to qualify. 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.

Income and Asset Limit

‍To qualify, a veteran (or spouse) must not have a net worth of more than $130,773 (in 2021), which will increase each year with cost-of-living adjustments. An applicant’s net worth is the total of the applicant's assets and income. A house (up to a two-acre lot) will not count as an asset even if the applicant is currently living in a nursing home. Applicants will also be able to deduct medical expenses from their income. 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 that provides some medical or nursing services; and the cost of an assisted living facility. These expenses must be unreimbursed (in other words, insurance must not pay the expenses). The expenses should also be recurring, meaning that they should recur every month.

Transfers and Penalties

‍There is also a three-year look-back to determine if the veteran transferred assets in order to qualify for benefits. Applicants will have to disclose all financial transactions they were involved in for three years before the application. 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. There are exceptions to the penalty period for fraudulent transfers and for transfers to a trust for a child who is unable to "self-support."

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 (MAPR) for a veteran with one dependent in need of aid and attendance. For example, assume the net worth limit is $130,773 and an applicant has a net worth of $117,773.

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 $147,773, which exceeds the net worth limit by $17,000. The penalty period will be calculated based on $17,000, the amount the applicant transferred that put his assets over the net worth limit ($147,773-$130,773). The VA then takes the MAPR and divides it by 12 to create a penalty rate. So if the MAPR is $23,238, the penalty rate is $1,937 ($23,238/12). The length of the penalty is then determined by dividing $17,000 by the penalty rate of $1,937, which equals 8.78, but is rounded down to 8 months.

Annual Pension Rate (MAPR)

Following are the MAPRs for 2021:
Single veteran $23,238
Veteran with one dependent $27,549
Single surviving spouse $14,934
Surviving spouse with one dependent $17,815

Amount of Benefit

‍The amount a person receives depends on his or her income. The VA pays the difference between the veteran's income and the MAPR.

Here's an example: John, a single veteran, has income from Social Security of $16,500 a year and a pension of $12,000 a year, so his total income is $28,500 a year. He pays $20,000 a year for home health care, $1,122 a year for Medicare, and $1,788 a year for supplemental insurance, so his total medical expenses are $22,910. Subtracting his medical expenses from his income ($28,500 - $22,910), John's countable income is $5,590. John could qualify for $17,648 ($23,238 - $5,590) in Aid and Attendance benefits.

To find out if you are eligible for Aid and Attendance benefits, contact your attorney.

To apply, contact a VA office near you.

For the VA's Guide to Long-Term Care, click here