Long-term care costs can add up quickly for families. For veterans (and their surviving spouses) who need in-home care or are in a nursing home, help is often available.
The Veterans Administration (VA) has an underused pension benefit called Aid and Attendance. This benefit provides money to those who need assistance performing everyday tasks. 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 expenses for which they do not receive reimbursement.
Aid and Attendance
Aid and Attendance is a pension benefit, which means it is available to 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 daily activities of living, such as bathing, getting dressed, or going to the bathroom. 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 $150,538 (in 2023). (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 veteran transferred assets in order to 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 to meet the net worth 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.
There are exceptions to this. 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 in terms of number of months. Imagine a veteran with one dependent and in need of aid and assistance. 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 $150,538, and their net worth when they apply is $120,538. 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 $160,538. This would have exceeded the net worth limit by $10,000.
In this case, how would the VA determine how many months the penalty period lasts? It would begin this calculation with the $10,000. This is the amount the applicant transferred that would have put their assets over the net worth limit ($160,538-$150,538). The VA then takes the MAPR and divides it by 12 to create a penalty rate.
So, if the MAPR is $31,714, the penalty rate is $2,642 ($31,714/12). The VA would then divide the $10,000 by the penalty rate of $2,642. This equals 3.78; the VA would round up the penalty period to four months.
Annual Pension Rate (MAPR)
The following are the MAPRs for 2023:
- Single veteran = $26,752
- Veteran with one dependent = $31,714
- Single surviving spouse = $17,888
- Surviving spouse with one dependent = $21,130
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 of $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 add up to $22,910. Subtracting her medical expenses from his 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.
To find out if you are eligible for Aid and Attendance benefits, contact a qualified attorney near you.
For additional information, check out the following resources: