The harsh rules governing Medicaid eligibility make Veterans benefits even more important. Aid and Attendance benefits are important in elder care of a veteran or a veteran's spouse, if t he veteran has served ninety consecutive days active duty, with at least one day during war time, honorably discharged.
To qualify a veteran or his spouse for the Aid and Attendance pension, the VA regulations look at whether some or all of the claimant’s estate should be consumed for the claimant’s maintenance. The VA considers:
- 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”
- potential rate of depletion, including unusual medical expenses under the principles outlined in 38 CFR §3.272(g) for claimant and dependents
Aid and Attendance benefits can be combined with Social Security and pension income, to make long term care planning work for veterans and their spouses. Aid and Attendance benefits can also be used for care at home.
Community Health Benefits for at home care are also available from the VA, if the veteran is enrolled in the VA, and has a primary care physician in the VA. The primary care physician puts in a referral, and the VA then purchases services from a local Visiting Nurse Association or other contractors:
- Skilled Services: Nursing OT, PT, Speech therapy
- Home Health Aides: assist with ADLs, showers – Number of hours depends on the situation. No more than 21 hours per week.
- Respite
- Home hospice
- Adult Day Healthcare - VA purchases services through local agencies. Van or busses transport.
There is no co pay if the need for care is 70% service connected. Service connected percentage can be assigned at any time. The most the veteran would be charged is $15/ visit. Co-pay depends on income.
Adult Day Healthcare is provided by the VA through local agencies. Van or busses transport. Thayer Care in Hadley, Mercy Adult Day Healthcare in Westfield and Holyoke Geriatric Authority.
Prescription benefits for widows and and for veterans.
VA Nursing Home Care at Leeds, Massachusetts: The enrollment staff and social workers conduct a one on one review of each case. The official VA benefits brochure explains: “While some veterans qualify for indefinite nursing home care services, other veterans may qualify for short-term services.
Among those who automatically qualify for indefinite nursing home care are veterans whose service-connected condition is clinically determined to require nursing home care and veterans with a service connected rating of 70% or more.
Other veterans – with priority given to those with service connected conditions – may be provided short term nursing home care if space and resources are available.” Waiting lists and income and asset assessments are part of the process.
The Department of Veterans Affairs has published rules at 38 CFR 17.111 on VA co payments and how much money a spouse can keep, if the veteran is receiving long term nursing home care from the VA. A spouse can keep a primary residence, and some other assets. These rules are similar to the rules for MassHealth and Medicaid. The availability of care can prove more options to married couples who need care now, or may need care in the future.