“Aid and Attendance” is a special pension benefit available to Veterans and their spouses to help pay for the cost of medical care. If the Veteran qualifies, they are entitled to receive a monthly check from the Department of Veteran’s Affairs. The VA itself has said that the Aid and Attendance Pension is an underutilized benefit, and that less than 10% of eligible veterans are currently taking advantage of the funds available to them.
Maximum Aid and Attendance Benefit for 2017:
Applicant Status/Maximum Benefit (2017)
There are several areas in which the Veteran must be found qualified.
1. War Time Service:
- 90 consecutive days on active duty military service;
- Better than a Dishonorable Discharge
- Served at least one day of active duty during a war period. There is no requirement that this was in a combat zone.
2. Medically Qualified:
- The Claimant must be certified by a doctor as needing assistance with activities of daily living (e.g. bathing, dressing, cooking, walking).
3. Financially Qualified:
- Net Worth: There is no exact amount of assets that will automatically qualify or disqualify a Veteran. It used to be that if a married Veteran had less than $80,000.00 of Allowed Countable Assets, the VA would generally award Aid and Attendance. The amount now appears to be much lower, and is subject to the discretion of the VA. The VA itself defines what is countable for calculating net worth as: “such assets as bank accounts, stocks, bonds, mutual funds, and any property other than the veteran’s residence and a reasonable lot area.”
- Income: The Adjusted Household Income must be less than the Aid and Attendance Benefit. Adjusted Household Income is determined by subtracting unreimbursed medical expenses (UMEs) from gross income.
A very simple example of how medical expenses can reduce household income: John, a Korean War veteran, and his wife Mary have total gross monthly income (social security, pension) of $4,051.00, and they have less than $40,000.00 of assets. Because of John’s health, they want to move to an Assisted Living Facility. The facility costs $6,000.00 per month.
Gross Income: $4,051.00
UMEs -$6,000.00 (other UMEs may also be added)
($1,949.00) Monthly shortfall
Since John and Mary’s UMEs are greater than their income, it is likely that they will qualify for A&A.
Aid and Attendance is a special pension offered by the VA that helps Veterans pay for the cost of their medical care. A&A is intended to preserve and extend a Veteran’s assets by reducing their amount of out-of-pocket payments. Medicaid, on the other hand, pays for the entire cost of nursing home care after the applicant’s income has been given to the nursing home.
Currently, the VA does not have any look-back rules that restrict gifting of assets to reduce net worth, however, in 2016 the VA proposed enforcing a look-back period. The VA has not yet released the final rules on this proposal. Medicaid imposes a penalty for any assets that were given away within 60 months of applying for benefits. [WARNING: even though the VA currently allows gifting, there may be other consequences to gifting assets. Please do not transfer any asset until you consult with your attorney or tax advisor.]
Aid and Attendance is a pension benefit, and when the claimant dies, the benefit simply stops – there is no estate recovery or payback required. Medicaid, by law, must attempt to recover any amount paid on behalf of the applicant from their estate. On a practical note, since the applicant may have only $2,000.00 in order to qualify for Medicaid in the first place, there is generally nothing remaining that will ever need to be paid to Medicaid.
If a person receiving A&A moves to a nursing home, and is approved for Medicaid, the monthly benefit is reduced to $90.00 a month. Medicaid, however, does not consider this “income” to the applicant, so the $90.00 does not have to be paid to the nursing home.
A&A is a benefit that is often overlooked, and in many cases allows a Veteran and/or their spouse to remain living in an Assisted Living Facility when their assets would otherwise be depleted.
More information on Aid and Attendance:Veterans Pension Program