Medicaid long-term care benefits and strategies that can be implemented to protect your mother’s estate. However, the federal government also offers VA benefits that can assist with long-term care. Here is a brief discussion of each program offered by the VA:
Aid & Attendance (A&A)
The Aid & Attendance monthly pension amount may be added to your mother’s monthly pension if she meets one of the following conditions:
- Your mother requires the aid of another person in order to perform the functions of everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting herself from the hazards of her daily environment.
- Your mother is bedridden, meaning her disability requires that she remains in bed.
- Your mother is living in a nursing facility due to mental or physical incapacity.
- Your mother’s eyesight is limited to a corrected 5/200 visual acuity or less in both eyes, or concentric contraction of the visual field to 5 degrees or less.
In addition, an increased monthly pension may be given if your mother is substantially confined to her premises because of a permanent disability.
This is another government-based program available through the Veterans Administration. This book really isn’t designed to offer an in-depth analysis of this program, but understand that all of the following eligibility requirements must be met for your mother to qualify for these benefits:
- Your mother or her spouse was discharged from service under other than dishonorable conditions,
- Your mother or her spouse served 90 days or more of active duty with at least 1 day during a period of wartime (see the definition of wartime below),
- If your mother is using her spouse’s VA benefit, she did not remarry after the spouse's death,
- Your mother’s countable income is within the following table’s limits:
Veteran Family Status
Basic Pension Income Limit
Housebound Income Limit
Aid & Attendance Income Limit
Veteran with no dependents
Veteran with a non-veteran spouse or child (add $2,250 per child)
Surviving Spouse/Death Pension
- For Aid & Attendance: Your mother is disabled and needs to receive income for "assistance on a regular basis to protect [her] from hazards or dangers in [her] daily environment." If your mother is in a nursing facility, the VA presumes she has a need for "aid and attendance."
One very important rule is the requirement to serve during wartime. The wartime requirement is determined by Congress; the following are considered periods of war:
- World War I. April 6, 1917, through November 11, 1918, inclusive. If the veteran served with the United States military forces in Russia, the ending date is April 1, 1920. Service after November 11, 1918, and before July 2, 1921, is considered World War I service if the veteran served in the active military, naval, or air service after April 5, 1917, and before November 12, 1918.
- World War II. December 7, 1941, through December 31, 1946, inclusive. If the veteran was in service on December 31, 1946, continuous service before July 26, 1947 is considered World War II service.
- Korean conflict. June 27, 1950, through January 31, 1955, inclusive.
- Vietnam era. The period began on February 28, 1961, and ended on May 7, 1975, inclusive, in the case of a veteran who served in the Republic of Vietnam during that period. The period beginning on August 5, 1964, and ending on May 7, 1975, inclusive, in all other cases.
- Persian Gulf War. The period begins on August 2, 1990, and ends on the date thereafter prescribed by the Presidential proclamation or by law.
Unfortunately, the VA pension is not a great benefit for your mother if she is on Medicaid and in a nursing home. In that case, her pension is reduced to $90 per month. She may retain the $90 as a personal needs allowance, in addition to the $60 that any MEPD (nursing home Medicaid) beneficiary can keep out of his or her own income.
As of September 1st, 2018, VA has no transfer penalty rule, meaning your mother can gift away from her property without delaying eligibility for VA benefits. VA rules on resources are not readily available, but the limit is usually stated to be between $30,000 and $80,000. These rules may change in the future, so you should always talk to an attorney.
How to Apply
Your mother can apply for Aid & Attendance or Housebound benefits by writing to the Pension Management Center (PMC) located at the address below for the State of Texas:
St. Paul VA Regional Office
Department of Veterans Affairs
Claims Intake Center
Attention: St. Paul Pension Center
PO BOX 5365
Janesville, WI 53547-5365
In addition, you can get even more localized help by going to https://www.benefits.va.gov/waco/. This office services most of Texas. There is another office in Houston; you can go to their webpage at https://www.benefits.va.gov/houston/.
Remember that government employees want to help your mother, but they need documentation. Please gather all medical reports that validate the need for A&A or Housebound care. In addition, they will need to see all financial documentation. DO NOT LIE TO THE GOVERNMENT.