Senior Veterans Medical Benefits

The Department of Veterans Affairs (VA) has special programs that provide veterans and their widowed spouses with supplemental income that can help cover the costs associated with long-term care such as assisted living, home care, adult day care services or nursing care. But many veterans don’t know about these VA disability benefits — in fact, only about 5 percent of qualified veterans are receiving them. Here’s what you need to know.

What Is Aid & Attendance?
Benefit Amounts
Medical Criteria
Financial Criteria
Service Criteria
How to Apply
Denials and Reapplication

What Is Aid & Attendance?

Aid & Attendance is a nonservice-related tax-free pension paid monthly for the rest of the veteran’s or his/her dependent’s life. It is a direct deposit to your account.

“Aid & Attendance is intended to provide financial support to veterans and their loved ones to help reduce the cost of care in a senior living community,” said Abigail Anderson of Patriot Angels, an organization that assists veterans in navigating the complicated benefits application process. If the necessary care is in place, A&A can be used to offset the cost of room and board in an assisted or independent living community. It can also help offset the cost of a third-party care provider in a community or at your home.

Benefit Amounts

Payments are disbursed directly to you, and how much you receive every month will vary based on your counted income, number of dependents, assets and expenses. In 2018, the maximum annual A&A pension rates were:

• $22,577 for a veteran
• $32,724 for a veteran with one dependent
• $17,736 for surviving spouse of a qualified veteran

You must meet certain medical, financial and service requirements to qualify.

Medical Criteria

According to the VA, if you meet one or more of the following medical criteria, you could receive A&A benefits:

• You require the aid of another person to perform activities of daily living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices or protecting yourself from the hazards of your daily environment.
• You’re bedridden, which means that your disability requires you to remain in bed apart from any prescribed course of convalescence or treatment.
• You’re 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.

You may qualify for the Housebound benefit if you’re substantially confined to your immediate residence due to a permanent disability. It’s important to note that you cannot receive both the A&A and Housebound benefits at the same time.

Financial Criteria

As of October 18, 2018, there are new regulations regarding financial eligibility for the Aid and Attendance (A&A) pension program. The most significant of these changes is designed to help prevent the risk of senior financial exploitation by selling financial products, like annuities, to obtain pension eligibility.

Much like Medicaid, A&A now has a three-year look-back with a penalty period of up to five years, regarding the gifting and transferring of assets. With this new look-back period in place, the asset limitation will increase to $123,600, but will now include your income. The only remaining exemption is the ownership of your estate, unless you’re sitting on more than two acres.

Anderson is quick to point out that you shouldn’t assume you won’t be eligible. “A lot of people look at these requirements and automatically disqualify themselves, because they see they’re above the thresholds in front of them. But keep in mind if you’re currently receiving care, or expecting to soon, you could be spending enough of your income to actually qualify for aid.”

Receiving a disability pension (a service-connected pension) can affect your eligibility as well. Depending on your disability rating, you could be rated higher than the maximum amount of A&A, and therefore would be considered ineligible for a non-service-connected pension.

“Getting approval for disability benefits can take up to two years,” noted Anderson, “so some people apply for and receive A&A benefits while they’re waiting for their rating and approval.”

Service Criteria

Those who receive a VA pension must meet minimum duty requirements. You must have served at least 90 days of active duty, with one of those days having been during a period of active war. And you must have received a general, honorable or medical discharge.

Eligible wartime periods are:

• Mexican Border Period (May 9, 1916-April 5, 1917 for veterans who served in Mexico, on its borders or adjacent waters)
• World War I (April 6, 1917-November 11, 1918)
• World War II (December 7, 1941-December 31, 1946)
• Korean conflict (June 27, 1950-January 31, 1955)
• Vietnam era (February 28, 1961-May 7, 1975 for veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964-May 7, 1975)
• Gulf War (August 2, 1990 through a future date to be set by law or Presidential Proclamation)

Determining eligibility can be tricky and time-consuming. To make it easier, download these additional resources before starting the application process.

How to Apply

There are two direct ways to apply for A&A or Housebound benefits:

• Through the Pension Management Center (PMC) that serves your state
• Through your local regional office to file

No matter how you apply, here’s what you need to do to get started:

Step One: Gather financial information about your income and net worth, medical records, and a written doctor’s report verifying the need for aid and attendance.

Step Two: Once you have that information, it’s time to submit your intent to file through one of the regional offices. You’ll receive a letter from the VA with a file number, which means you have officially opened a claim.

Step Three: This is actually a series of steps involving a lot of paperwork and communication with the VA. From the time of your initial submission, the VA typically takes 10-12 months to review your information and either approve or deny your claim.

It’s recommended you send all information via Certified Mail Return Receipt so you have verification that it’s actually been received. Be sure to keep a copy of your application and all VA correspondence for your own records.

Denials and Reapplication

“Don’t underestimate the complexity of the process,” added Anderson. “Even if you have been prequalified and know that you’re eligible, that doesn’t make the process any easier. You still must apply and wait for approval. If one ‘T’ isn’t crossed or one ‘I’ isn’t dotted, the administration can deny you.”

If you receive a hard denial, you may not be able to reapply for an additional 12 months. “This is a bind that a lot of families find themselves in,” Anderson said, “a bind that could have been prevented had they been given the right assistance.”

Seeking the advice of VA-accredited lawyers or a service such as Patriot Angels can help you determine your eligibility and navigate the process to receive the disability benefits you’ve earned.

Sources:

• Veterans Benefits Administration
• Patriot Angels
• Paying for Senior Care

Download guide

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