Va long term care benefits for spouses

VA Benefits For Long-Term Care of Veterans and Their Surviving Spouses

Many wartime veterans and their surviving spouses are currently receiving long-term care or will need some type of long-term care in the near future. The Veterans Administration has funds that are available to help pay for this care, yet many families are not even aware that these benefits exist. Attorney Adam Demetri is certified by the Veterans Administration to represent veterans pursuing pension benefits.

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VA Benefits For Long-Term Care of Veterans and Their Surviving Spouses
Who qualifies for Aid and Attendance benefits?
How to get help with the application process

Pension with Aid and Attendance pays the highest amount and benefits a veteran or surviving spouse who requires assistance in activities of daily living (dressing, undressing, eating, toileting, etc.), is blind, or is a patient in a nursing home. Assisted care in an assisted living facility also qualifies.
Pension with Housebound Allowance is for those who need regular assistance but would not meet the more stringent requirements for Aid and Attendance, and wish to remain in their own home or the home of a family member. Care can be provided by family members or outside caregiver agencies.
Basic Pension is for veterans and surviving spouses who are age 65 or older or are disabled, and who have limited income and assets.

Qualifying for Benefits
A veteran does not need to have service-related injuries to qualify for these pension benefits, but must meet certain wartime service and discharge requirements. A surviving spouse must also meet marriage requirements to the qualified veteran. Certain requirements must be met for a disability claim if the claimant (the veteran or surviving spouse filing for benefits) is less than age 65.

When determining eligibility, the VA looks at a claimant’s total net worth, life expectancy, income and medical expenses. A married veteran and spouse should have no more than $80,000 in “countable assets,” which includes retirement assets but does not include a home and vehicle. This amount is a guideline and not a rule.

Income for VA Purposes (called IVAP) must be less than the benefit for which the claimant is applying. IVAP is calculated by subtracting “countable medical expenses” (recurring out-of-pocket medical expenses that can be expected to continue through the claimant’s lifetime) from the claimant’s gross income from all sources.

Note: It is possible to reduce assets and income to a level that will be acceptable to the VA. For example, excess liquid assets (such as cash or stocks) could be converted to an income stream through the use of an annuity or promissory note, or transfered to a Veterans Asset Protection Trust (VAPT) . However, because the claimant may need to qualify for Medicaid in the future, it is critical that any restructuring or gifting of assets be done in a way that will not jeopardize or delay Medicaid benefits. An attorney who has experience with Elder Law will be able to provide valuable assistance with this.

Applying for Benefits
It often takes the VA more than a year to make a decision, but once approved, benefits are paid retroactively to the month after the application is submitted. Having proper documentation (discharge papers, medical evidence, proof of medical expenses, death certificate, marriage certificate and a properly completed application) when the application is submitted can greatly reduce the processing time.

Because time is critical for these aging veterans and their surviving spouses, application should be made as soon as possible. For more information, visit http://www.va.gov.

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En español | The crushing cost of long-term care in a nursing home or assisted living facility, or for a caregiver within your own home, can quickly deplete your retirement savings. But many veterans are eligible for a valuable benefit, Aid and Attendance, that can help offset those costs for life. The application process for the Department of Veterans Affairs’ (VA) benefit program can be long and complicated, but you could receive as much as $2,200 per month to help pay for care if you're eligible.

Beth Agnello's dad, Les, served in the Navy during World War II, attended college on the GI Bill, and then spent more than 40 years teaching physics and physical education in Richmond, California. He and his wife, Gene, moved to a retirement community when they were in their mid-80s.

Les started showing signs of cognitive impairment, and after Gene had a stroke in April 2010 they both needed extra help and moved to an assisted living facility. Suddenly, their living expenses exploded — topping $4,000 per month. The facility's director knew that Les was a WWII veteran and told Beth that he was likely to qualify for the VA's Aid and Attendance benefit to help cover the cost of care.

Beth went to a local Veterans Service Organization (VSO) office for help — VSOs are organizations that assist veterans with VA claims — and ended up working with an expert from the American Legion who knew how to navigate the complicated application process. Gene died in December 2010, but Les remained in assisted living. After mounds of forms and several long letters to and from the VA, Les started to receive Aid and Attendance benefits about six months later. It paid more than $1,600 per month for 10 years, until he died in February 2020 at age 98.

Between his teacher's pension and his Aid and Attendance benefits, he was able to cover the cost of care — first in California, then when he moved to a more expensive facility in North Carolina to be near Beth — without having to deplete his small nest egg. He had enough money left over that he could attend minor league baseball games of his beloved Winston-Salem Dash with her until the year before he died.

Many wartime veterans get older and need help with the activities of daily living, but are unaware of benefits they are eligible for or are intimidated by the time-consuming application process. “People just don't know that this benefit exists,” says Matthew Margolis, an estate planning and elder law attorney in Park Ridge, Illinois. He helps clients figure out if they're eligible for Aid and Attendance or other long-term care benefits.

The benefits can be incredibly valuable, providing a monthly payout for as long as the veteran (or surviving spouse) needs care. In 2020, veterans with one dependent (usually a spouse) who need care can receive up to $2,266 per month in Aid and Attendance benefits (which is more than $27,000 per year), or up to $1,911 per month without a dependent, depending on their income and cost of care. Surviving spouses of eligible veterans can receive up to $1,228 per month if they need care after the veteran dies. You can use the benefits in a nursing home, assisted living facility or for care in your own home if you meet the eligibility requirements and need help with activities of daily living.

Who qualifies for Aid and Attendance benefits?

To qualify for Aid and Attendance, the veteran must be at least 65 years old or have a permanent and total disability and meet the service, asset, income and medical requirements. The surviving spouse of an eligible veteran can also receive the benefit if he or she needs care.

Service requirement: The veteran must have had at least 90 consecutive days of service, with at least one day of active service during these times of war:

WWII: Dec. 7, 1941, to Dec. 31, 1946
Korean conflict: June 27, 1950, to Jan. 31, 1955
Vietnam War era: Aug. 5, 1964, to May 7, 1975
Gulf War: Aug. 2, 1990, until the present

For a list of full requirements go to the Eligibility for Veterans Pension page at VA.gov. The veteran doesn't need to have retired from the military but can't have a dishonorable discharge.

Asset requirements: The VA changed the asset calculation a few years ago to make it more simple to apply. In 2020, the veteran (and spouse, if married) must have less than $129,094 in assets, including bank accounts, investment accounts, IRAs, other retirement accounts, and the cash value of life insurance, excluding the veteran's home. This asset level is adjusted for the cost of living each December.

Income requirements: The income criteria is complicated. “Basically, they need to be in a situation where their monthly cost of care exceeds their monthly income,” says Margolis. See VA Pension Rates for Veterans for more information about the calculation.

Medical requirements: A doctor usually must certify that you need help with activities of daily living such as bathing, eating and getting dressed. Nursing home patients need to provide extra paperwork from the facility about the costs and type of care they receive.

How to get help with the application process

The application process can be daunting. “There is nothing about the process that is seamless,” says Beth, who has an MBA and is now a financial planner. “But help is out there; don't give up.”

Margolis says the time to complete the process can range from a month or two up to about seven to nine months. If benefits are approved, they can be paid out retroactively from the month after the VA received your application, he says.

The application plus supplemental forms can be more than 50 pages long, says Victoria Collier, an elder law attorney who is accredited with the VA and co-owner of Patriot Angels, which specializes in helping veterans with Aid and Attendance and other long-term care benefits (you can search for an accredited attorney and other representatives through the VA's Accreditation Search). Its clients start to receive benefits an average of 118 days after applying, says Collier. It charges $795 for its services.

You can find a VSO in your area that provides free assistance here, which is how Beth found the expert from the American Legion. Some estate planning attorneys also help people with Aid and Attendance benefits as part of their elder law services. A financial planner or geriatric care manager may also recommend a specialist who can help. Byron Cordes, a geriatric care manager in San Antonio, is helping people search for long-term care facilities and caregivers. He refers veterans who seem to meet the criteria to an elder law attorney who has expertise in these benefits. “In Texas, it can pay almost half of the nursing home costs,” he says.

Beware of salespeople who claim they'll help you qualify for Aid and Attendance benefits if you purchase high-commission products. The VA added a three-year lookback period in October 2018, so any money you give away or use to buy certain trusts or financial products within that time period can delay your eligibility for benefits.