Aid is Available for Veterans and their Surviving Spouses to Help Pay for Long-term Care

As recently as 2012, Gallup estimates that about 13% of adults, including 24% of men and 2% of women, have served in the United States Armed Forces.[i]   For their service to our country, veterans are entitled to a variety of benefits through the U.S. Department of Veterans Administration (VA).

The fact is that many of our veterans and their spouses are aging or have a disability. Often, they require assistance with meeting their everyday personal care needs. Paying for this care can be very expensive. Assisted living facilities in Northeast Ohio typically cost between $4,500 to $6,000 or more per month.[ii] For veterans and their survivors, there may be help available. An important, but often overlooked, VA benefit is Aid & Attendance.

Put simply, Aid & Attendance provides compensation for those who are eligible and require the aid and attendance of another person. The individual in need of care must need the aid of another person to perform the personal functions required in everyday living. These are known as Activities of Daily Living (ADLs). ADLs include, among other needs, bathing, feeding, dressing, and attending to the “wants of nature.” Aid & Attendance may be received in the home, an assisted living facility, or a nursing facility.

Compensation may also be available to those who do not need regular aid and attendance, but are housebound. To receive compensation under the housebound allowance, which provides a lesser benefit than Aid & Attendance, the veteran or survivor must be substantially confined to his or her immediate premises because of permanent disability and need some assistance with ADLs.

To qualify, the veteran must have been discharged under conditions that were not dishonorable and have 90 days of continuous military service, at least one day of which was during a period of conflict. Periods of conflict include World War II, Korean War, Vietnam War, and for any veteran serving from August 2, 1990, onward.

In 2015, the maximum Aid and Attendance benefits are:

Married Veteran:                                                           $2,120 per month (or $25,448 per year)

Veteran with no spouse or dependents:                           $1,788 per month (or $21,466 per year)

Surviving spouse:                                                           $1,149 per month (or $13,794 per year)

The veteran and spouse must be financially eligible for Aid and Attendance. Under current law, there is no set test for the amount of assets an individual or couple may keep and still be eligible. The veteran or surviving spouse’s home or car do not count as an asset. However, the goal of the program is to provide care for needy individuals. Typically, total assets must be below $80,000 to qualify.

Under current law, veterans and spouses are permitted to transfer assets under certain circumstances and be found eligible for Aid & Attendance. However, the VA has proposed a rule which would impose penalties similar to asset transfer penalties for Medicaid.[iii] It is not clear that the new rule will go into effect. However, anyone considering transferring assets should always have appropriate legal or professional advice first.

To qualify, countable income must be below the yearly maximum benefit (described above). However, even veterans and spouses who have several thousand dollars of income per month may still qualify if the unreimbursed care expenses are high enough. Unreimbursed medical expenses for the cost of care can quickly reduce the veteran and spouse’s income to zero or less.

For instance, in a simplified calculation, if a single veteran has a monthly income of $4,500 but pays $4,500 per month for assisted living services other than room and board, her or his income is zero.[iv] This qualifies the veteran for the maximum monthly Aid & Attendance benefit of $1,788.

Monthly Gross Income:                                                    $4,500

Less Monthly Unreimbursed Medical Expenses:                    $4,500

Monthly Countable Income:                                                   $0

Entitled to Maximum Monthly Benefit:                               $1,788

In my practice, I have found that Aid & Attendance is particularly helpful if the veteran or survivor needs care to remain in an assisted living facility. At $1,788 or $1,149 per month, the benefit is not high enough to provide much assistance with paying for much higher cost of care in a nursing facility. The cost of care in a nursing facility in Northeast Ohio typically can be as low as $7,000.00 to as much as $15,000 per month or more. Individuals who need help paying for the cost of nursing facility care typically must rely on Medicaid.

Aid & Attendance can also help the veteran or spouse to remain in the home. Importantly, unreimbursed costs of care paid to a family member or friend in the home may be used to reduce income and meet the eligibility requirements.

For more information, contact your local Veterans Service Office (VSO). Every county in Ohio has an office. VSO representatives can help you make a claim for VA benefits and do so without charge to you. Click here to find your local VSO.

You should consider consulting with a qualified elder law attorney who is accredited to practice before the VA before making any application. Making an application for VA benefits may affect your estate plan and ability to access other important government benefits, such as Medicaid. The attorneys at Hickman Lowder regularly handle cases involving planning for care needed for an elder or person with a disability.



[ii] For more information regarding the cost of care, Genworth has published data by state and locality: https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-of-care.html Visited August 14, 2015

[iv] The actual calculation is more complex as the VA will only deduct unreimbursed medical expenses in excess of five percent (5%) of its basic pension rate.   38 C.F.R. § 3.272 (2015)

Posted in Blog, Older Adults.