When to turn to VA for help with Long-Term Care
Copyright © 2012, Douglas D. Germann, Sr., Professional Corporation.
574/291-0022, fax 574/291-0024, PO Box 2796, South Bend, IN 46680-2796
There are two main programs to help folks pay for the care they need in Long-Term Care settings: VA and Medicaid.
Why would you want this help? Why not just spend your own money till it runs out, and then let the government step in?
- Mom. If Dad is needing a lot of help, time-consuming, worry engendering, expensive help, what about Mom? Is Mom’s health affected by the extra care she needs to give Dad? Is it stressful? Does her sleep suffer? Does she put off going to the doctor for herself? Does she have little time for herself? Could they spend all the money on Dad, and leave nothing for quality care for Mom if she should need it? All of these are true in many families.
- Dad. Could we improve the quality of care Dad gets if the VA or Medicaid is helping with the basic bill, freeing up our money to provide above and beyond the basics? Might Dad need more therapy than these programs cover? Might Dad do well with more than the prescribed number of doctor visits? Could Dad use glasses or dentures more than once a year? Would it be great to buy plane tickets for grandchildren to visit? Easing up on the demands on family funds can help in many ways.
So you have these two programs to help you. Which do you use when?
VA is relatively easy to qualify for, takes a long time to respond to applications, and pays a lot less of the bill.
Medicaid is relatively hard to qualify for, responds relatively quickly, and pays the most toward the bill.
Veterans Administration Aid and Attendance
The Veterans Administration Aid and Attendance program helps pay for the help you need, whether at home, in assisted living, or in a nursing home.
The maximum they currently pay is about $2,000 per month. With assisted living currently starting in the range of about $4,000 per month in northern Indiana, the VA benefit helps but does not cover the whole bill.
Since it pays for help at home, and can even pay for family members to provide the services, it is ideal if your needs are less.
In order to qualify, you must not just have a need for help with your activities of daily living, but there is a financial qualification (a sliding scale, based upon how the VA worker thinks your assets will hold out, given your age and health), and a war service requirement (must have an other than dishonorable discharge, must have served at least a day during time of war, must have served at least 90 days).
It regularly takes the VA 6 months to a year to decide on your application—and many of these need to go to appeals to get benefits.
Medicaid in Indiana
Medicaid on the other hand pays for all of your nursing home bill (usually not assisted living or at home) that your income or insurance policies do not cover.
However, your assets must be below $1,500, and your spouse’s below approximately $113,000, plus the home your spouse lives in. There are exemptions that can be used to preserve even more than these amounts for Mom and Dad. Medicaid is required to respond quickly, and usually an answer comes within 2-3 months. Again, appeals might be necessary.
Can you get both VA and Medicaid? Technically yes: if you qualify for both, you get an extra $38 per month spending allowance! Not worth the trouble for many folks.
So when would you use one or the other?
Use VA to help with at-home and assisted living facility times. Use Medicaid for nursing homes.
Here’s the rub: many of the things people do to qualify for VA can run you afoul of the Medicaid transfer of assets rules. In other words, making a gift of assets to your children can immediately get your assets down so you qualify for VA benefits, but the same gifts can disqualify you for Medicaid if you should need Medicaid within 60 months of making the gifts. Or again, buying an annuity sounds great, but it could put your income over limits, or even (and illogically) be deemed a violative gift!
There are ways to thread yourself safely through these dark and dense woods, but they take study, and caring, and fitting to your situation. What works for your friend might not work for you.
Douglas D. Germann, Sr., Professional Corporation P.O. Box 2796, South Bend, IN 46680-2796 telephone 574/291-0022; fax 574/291-0024 email [email protected]