About 70 percent of adults age 65 and older will need long-term care services at some point in their later years. Costs for this type of care can accumulate quickly for families across the United States. For military veterans (and their surviving spouses) who need in-home care or are in a nursing home, help is often available.
The Department of Veterans Affairs (VA) has an underused pension benefit called Aid and Attendance. This benefit provides money to those who need assistance performing activities of daily living (ADLs). These kinds of everyday tasks involve personal care including feeding bathing, dressing, and feeding oneself.
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 services expenses for which they do not receive reimbursement.
Aid and Attendance
Aid and Attendance is a pension benefit. This means it is available to military 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 their surviving spouse) are eligible if they need help performing activities of daily living. These kinds of everyday tasks involve personal care including feeding bathing, dressing, and feeding oneself. This includes individuals who are bedridden, blind, or residing in a nursing home.
Income and Asset Limit
To qualify, a veteran (or their spouse) must not have a net worth of more than $155,356 (in 2024). (This limit increases 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 2-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 who 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 lookback to determine whether the military veteran transferred assets to ensure they would qualify for benefits. Applicants involved in any financial transactions during the three years before they apply for benefits should therefore disclose these transactions.
Applicants who transferred assets within three years of applying so they could meet the net limit will face a penalty period. This penalty period can last as long as five years. During this time, the person who transferred assets is not eligible for VA benefits.
Some exceptions to this exist. For example, fraudulent transfers will not incur a penalty. Neither will transfers to a trust for a child who is unable to "self-support."
The VA determines an applicant's penalty period by number of months. Imagine a veteran applicant with one dependent who is in need of aid and attendance. The VA looks at the amount that the veteran transferred that would have put them over the net worth limit. It then divides this by the maximum annual pension rate (MAPR).
For example, assume the applicant's net worth limit is $155,356, and their net worth when they apply is $120,356. The applicant transferred $40,000 to a friend during the lookback period. If the applicant hadn't transferred the $40,000, their net worth would have been $160,356. This would have exceeded the net worth limit by $5,000.
In this case, how would the VA determine how many months the penalty period lasts? It would begin this calculation with the $5,000. This is the amount the applicant transferred that would have put their assets above the net worth limit ($160,356 minus $155,356). The VA then takes the MAPR and divides it by 12 to create a penalty rate.
So, if the MAPR is $32,729, the penalty rate is $2,727 ($32,729 divided by 12). The VA would then divide the $5,000 by the penalty rate of $2,727. This equals 1.83; the VA would round up the penalty period to two months.
Annual Pension Rate (MAPR)
The following are the MAPRs for 2024:
- Single veteran = $27,609
- Veteran with one dependent = $32,729
- Single surviving spouse = $18,461
- Surviving spouse with one dependent = $21,807
Amount of Benefit
The amount a person receives depends on their income. The VA pays the difference between the veteran's income and the MAPR.
For example, Lila, a single veteran, has income from Social Security totaling $16,500 a year. She also has a pension of $12,000 a year, so her total income is $28,500 a year.
She pays $20,000 a year for home health care, $1,122 a year for Medicare, and $1,788 a year for supplemental insurance; her annual medical expenses therefore equal $22,910. Subtracting her medical expenses from her income ($28,500 minus $22,910), Lila's countable income is $5,590. She could qualify for $21,162 ($26,752 minus $5,590) in Aid and Attendance benefits.
Learn More About A&A for Military Veterans
To determine whether you are eligible for Aid and Attendance benefits, contact a qualified elder law attorney near you. These professionals can also help you with other potential long-term care planning options. Consider partnering with them on understanding how you might find ways to afford for long-term care.
For additional information, check out the following resources:
- Contact your local VA office.
- The Veterans Administration Guide to Long-Term Care
- Reasons Veterans Miss Out on Veteran Disability Benefits
- What Are Veterans Death Benefits?
- CRDP and CRSC Support Retired Disabled Veterans