Joe, an 89-year-old veteran served in WWII. He and his wife, Mary, have been living in an assisted living facility for three years and Joe has been receiving VA Pension with Special Monthly Pension for Aid and Attendance. Joe recently fell, and his physician has decided Joe cannot return to the assisted living facility. Joe is now in a Nursing Home and needs to apply for Medicaid to cover the cost of his care.
VA Pension Benefits can be a lifesaver for veterans or their surviving spouses who need home care or assisted living facility care. The added money the VA awards eligible veterans or their surviving spouses when added to social security income is often just enough to help a veteran or spouse afford to stay at home with companion care or be able to move to a good assisted living facility (ALF).
When a veteran, his or her spouse or surviving spouse needs skilled nursing care in a skilled nursing facility or nursing home, though, the VA Pension is often not enough to cover the cost of that level of care. The average cost of a semi-private room in a nursing home in Georgia is about $181.00/day or about $5430.00 for a 30-day month, according to the MetLife Survey of Long-Term Care Costs published in November of 2012. For 2014, the maximum VA Pension award for a married couple is $2085.00. *(This maximum amount includes Basic Improved Pension plus Special Monthly Pension for Aid and Attendance). Currently, the Social Security Administration estimates that the average Social Security benefit for an aged couple when both are receiving benefits is $2,111., while the average for a single aged widow or widower is $1243 per month. Since the combined VA Pension and Social Security rarely exceed the $5000 monthly price tag for a nursing home stay, the veteran or spouse may need to qualify for Medicaid in order to afford to live in the nursing home.
Medicaid is a federal/state program available to people with low assets and income who meet the physical requirements for admission to a nursing home. Generally, that means that the person is deficient in some of the activities of daily living. While circumstances vary, usually a Medicaid recipient pays his or her monthly income to the nursing home, and then Medicaid pays the difference up to the amount Medicaid has contractually agreed to pay the nursing home.
A single veteran who qualifies for Medicaid will have his entire VA pension benefit reduced to $90.00. If a veteran is married and qualifies for Medicaid, whether or not he can continue to receive Improved Pension will depend on whether his spouse’s income is sufficiently reduced by unreimbursed medical expenses to make them eligible for the Improved Pension award.
A married veteran can still receive the VA pension benefit and the additional part considered to be aid and attendance, so long as he would be otherwise eligible for the benefit. If the income of the couple is less than the pension amount, the award can be apportioned to the spouse who is not in the Nursing Home and receiving Medicaid.
If Joe goes into the Nursing Home and begins receiving Medicaid, his Pension with Aid & Attendance can be apportioned for Mary to spend on her Assisted Living Care.