Helping Veterans Pay for Long-Term Care
There are currently over 21 million veterans alive in the United States. Many of these veterans are receiving long term care or will need some type of long term care in the near future, and there are funds available from the Veterans Administration (VA) to help pay for that care. Unfortunately, many of those who are eligible have no idea that any type of benefits exist for them or that an attorney can help them become eligible.
Benefits Available: There are many types of benefits available to veterans ranging from Compensation and Pension to Education and Training. Below is an overview of the Pension benefits that will assist a Veteran and surviving spouse in paying for their long term care needs. These benefits do not require that the Veteran’s disability be connected to their time in service (Non-service connected benefits).
Veterans Pension – is a tax-free monthly cash payment to low-income wartime Veterans. In order to qualify for this benefit, a Veteran must have at least 90 days of active duty service, with at least one day during a wartime period. If you entered active duty after September 7, 1980, generally you must have served for at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions), with at least one day during a wartime period. In addition, the Veteran must be age 65 or older, OR totally and permanently disabled, OR a patient in a nursing home receiving skilled nursing care, OR receiving Social Security Disability Insurance, OR Receiving Supplemental Security Income. Also, your yearly income must be less than the amount set by Congress. Go to http://va.gov/ to get the most current income and net worth limitations.
Survivors Pension – Also known as Death Pension, is a tax-free monthly cash payment payable to a low-income, un-remarried surviving spouse and/or unmarried child(ren) of a deceased Veteran with wartime service. The deceased Veteran must have met the service requirements described above for the Veterans Pension. Go to http://va.gov/ to get the most current income and net worth limitations.
Additional Pension Allowances – Veterans or surviving spouses who are eligible for VA pension and are housebound or require the aid and attendance of another person may be eligible for an increased monthly pension called Aid and Attendance (A & A).
Housebound – This increased monthly pension may be added to your monthly pension amount when you are substantially confined to your immediate premises because of permanent disability.
Pension with Aid and Attendance – The Aid and Attendance increased monthly pension amount may be added to your monthly pension amount if you meet one of the following conditions:
- You require the aid of another person in order to perform personal functions required in everyday living, otherwise known as activities of daily living. Such activities include bathing, dressing, feeding, toileting, transferring (from a bed to a chair), continence, and adjusting prosthetic devices, or protecting yourself from the hazards of your daily environment;
- You are bedridden, in that your disability or disabilities requires that you remain in bed apart from any prescribed course of convalescence or treatment;
- You are a patient in a nursing home due to mental or physical incapacity;
- Your 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.
Planning Note – Many times the most difficult task of benefit planning is to reduce a claimant’s assets down to the applicable level (or what one hopes will be acceptable to the VA). The assistance of legal counsel is important to ensure the right strategies are used, with minimal impact on Medicaid eligibility in the future.
Asset and Income Requirements – The financial eligibility requirements for any pension benefit concern a claimant’s net worth and income. A married veteran and spouse should have no more than $80,000 in countable assets (less for a single veteran or a surviving spouse), which includes retirement assets but excludes a home and vehicle. However, the $80,000 is only a guideline– it is not a rule set by the VA. Under 38 CFR §3.275(d), “in determining whether some part of the claimant’s estate should be consumed for the claimant’s maintenance, the VA considers the amount of the claimant’s income together with the following: Whether the property can be readily converted into cash at no substantial sacrifice; life expectancy; number of dependents who meet the definition of member of the family (the definition contained in §3.250(b)(2) is applicable to the improved pension program); potential rate of depletion, including unusual medical expenses under the principles outlined in §3.272(g) for the claimant and the claimant’s dependents.”
A veteran or surviving spouse must have Income for VA Purposes (IVAP) that is less than the benefit for which he or she is applying. IVAP is calculated by taking a claimant’s gross income from all sources less countable (unreimbursed) medical expenses. Countable medical expenses are recurring out-of-pocket medical expenses that can be expected to continue throughout a claimant’s lifetime (Must exceed 5% of the Maximum Annual Pension Rate (MAPR) for Service Pension). If a claimant’s IVAP is equal to or greater than the annual benefit amount, the veteran or surviving spouse is not eligible for benefits.
Conclusion – Time is of the essence for veterans or surviving spouses who may be eligible for pension benefits. It is imperative for those who work with veterans or surviving spouses of veterans to be aware of these benefits and to help potential claimants obtain legal help to qualify for pension benefits. If you know of someone who may be eligible, please give us a call.
Wartime Periods
| World War II | December 7, 1941 through December 31, 1946 inclusive. If the veteran was in the 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 beginning on February 28, 1961 and ending on May 7, 1975, inclusive in the case of a veteran who served in the Republic of Vietnam during that period. The period beginning August 5, 1964 and ending on May 7, 1975, inclusive in all other cases. | ||||||||
| Persian Gulf | August 2, 1990 through date to be prescribed by Presidential Proclamation or law. | ||||||||
| Future Dates | The period beginning on the date of any future declaration of war by Congress and ending on a date prescribed by Presidential Proclamation or concurrent resolution of Congress. | ||||||||
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REGISTER HERE for LONG-TERM CARE PLANNINGPower of Attorney
A Power of Attorney can be used to give another person the right to sell a car, home, or other property in the place of the maker of the Power of Attorney. A Power of Attorney might be used to allow another person to sign a contract for the maker of the Power of Attorney (the person who makes a power of attorney is called the “principal”). It can be used to give another person the authority to make health care decisions, do financial transactions, or sign legal documents that the principal cannot do for one reason or another. With few exceptions, Powers of Attorney can give others the right to do any legal acts that the makers of the Powers of Attorney could do them themselves. A General Power of Attorney gives the “power of attorney Agent” or simply “Agent” (the legal name of the person who is authorized to act for the principal) very broad powers to do almost every legal act that the principal can do. When Elder Law Attorneys draft general Powers of Attorney, they still list the types of things the Agent can do but these powers are very broad. People often do general Powers of Attorney to plan ahead for the day when they may not be able to take care of things themselves. By doing the General Power of Attorney, they designate someone who can do these things for them.
Normal Powers of Attorney terminate if and when the principal becomes incompetent. Yet many people do Powers of Attorney for the sole purpose of designating someone else to act for them if they cannot act for themselves. It is precisely when persons can no longer do for themselves that a Power of Attorney is most valuable. To remedy this inconsistency, the law created a Durable Power of Attorney that remains effective even if a person becomes incompetent. The only thing that distinguishes a Durable Power of Attorney from a regular Power of Attorney is special wording that states that the power survives the principal’s incapacity. Even a Durable Power of Attorney, however, may be terminated under certain circumstances if court proceedings are filed. Most Powers of Attorney done today are durable.
Yes. At the time the Power of Attorney is signed, the principal must be capable of understanding the document. Although a Power of Attorney is still valid if and when a person becomes incompetent, the principal must understand what he or she is signing at the moment of execution. That means a person can be suffering from dementia or Alzheimer’s Disease or be otherwise incompetent sometimes but as long as they have a lucid moment and are competent at the moment they sign the Power of Attorney, it is valid even if they do not remember signing it at a later date. At the time it is signed, the principal must know what the Power of Attorney does, whom they are giving the Power of Attorney to, and what property may be affected by the Power of Attorney.
Any competent person eighteen years of age and older can serve as an agent. Certain financial institutions can also serve. There is no course of education that agent must complete or any test that Agent must pass. Because a Power of Attorney is such a potentially powerful document, agents should be chosen for reliability and trustworthiness. In the wrong hands, a Power of Attorney can be a license to steal. It can be a big responsibility to serve as an agent.
For Medicaid
Medicare is health insurance and covers medical services such as physician appointments, therapy, blood tests, x rays, medical procedures and hospitalization. Medicare will sometime pay for rehabilitation in a long-term care facility for a period of 20 to 100 days, but not longer. In long-term care, Medicaid covers the cost of ongoing support services for daily functioning, such as room and board in a nursing home.
Medicaid is a federal program that is overseen by the Center for Medicare and Medicaid Services (CMS). In Pennsylvania, Medicaid is called Medical Assistance and is administered by the Department of Human Services (DHS).
In Pennsylvania, Medicaid funds are not available to pay for assisted living or personal care.
For Medicaid to pay for care in a nursing home, an individual recipient must be determined to need a nursing home level of care by a physician and the local Office of Aging. An individual whose income is not greater than three times the poverty level may keep up to $8,000 of total resources, but may otherwise keep only $2,400. The cash value of life insurance counts as a resource, but one car and a residential home does not count as a resource.
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Keystone Elder Law
At Keystone Elder Law, we believe that the physical, social, legal, and financial considerations of our clients all intertwine. We utilize an interdisciplinary approach to evaluate each area, which allows for the creation of a plan that addresses the concerns of the individual as a whole as well as the family. To this end, our model of practice includes a Care Coordinator (usually a nurse or social worker), whose expertise complements our team of attorneys.
When the road of life is smooth, decisions about legal and financial matters are easy to push aside for “a rainy day.” Planning ahead, however, will allow for more options as you view the map of where you’ve been and where you want to go. Don’t let a crisis limit your choices or derail your plans.
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