As we honor veterans this month on November 11, think about any veterans you know who may be dealing with the cost of elder care, such as paying for assisted living, home care, adult daycare, or skilled nursing facilities. If so, be aware that the Veterans Aid and Attendance benefit (A&A) could be a solution to help your friend, family member or client, offset rising care costs.
Determining eligibility isn’t always easy and each case is ultimately decided by the U.S. Department of Veterans Affairs (VA), but the general guidelines apply are:
- Veterans who served on active duty for at least 90 consecutive days, including at least one full day during a time of war, may be eligible if they also qualify for the basic Veterans Pension and meet the clinical and financial requirements.
- Service in a combat zone is not a requirement. Widowed spouses of eligible veterans may also qualify if they meet the clinical and income requirements and have not remarried.
Congress defines the wartime dates as:
- 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 Presidential proclamation or law (for VA benefits purposes, this time of war is still in effect).
In addition to the active duty and wartime service requirements, eligible veterans must also meet at least one of these criteria to qualify for the basic pension:
- Be 65 or older with no or limited income
- Have a permanent and total disability
- Receive Supplemental Security Income
- Receive Social Security Disability Insurance
- Reside in a skilled nursing facility
Veterans and surviving spouses who meet the eligibility requirements for the basic pension must also meet clinical and financial requirements to qualify for Aid and Attendance. They are:
Clinical Requirement for A&A
Veterans or surviving spouses must meet at least one of these clinical criteria:
- Be bedridden except for medical and therapy appointments and treatments
- Have severe visual impairment (eyesight limited to a corrected 5/200 visual acuity OR less in both eyes OR concentric contraction of the visual field to five degrees or less)
- Reside in a skilled nursing facility because of physical or mental incapacity, including Alzheimer’s and dementia
- Require help with some activities of daily living (ADL’s).
Financial Requirements for A&A
In December 2018, the VA set a clear upper limit for applicants’ net worth of $123,600, not including the applicant’s automobile, personal effects and residence. The VA also implemented a three-year lookback period to see if assets were sold below market value or gifted in a way that reduced net worth below the upper eligibility limit. If so, that may delay (but not necessarily prohibit) the start of VA pension benefit payments.
There’s also an upper limit on monthly countable income minus expenses such as unreimbursed medical bills, prescription out-of-pocket costs and Medicare and private health insurance premiums. (You can see a list of potential medical expenses here.) The VA pays benefit amounts that make up the difference between a recipients’ countable income and the monthly upper limit.
A helpful chart is available to determine pension rates. But, to give a sense for the amounts, here are a few examples:
- Aid & Attendance without dependents: maximum allowable pension is $22,577, with a monthly rate of $1,881
- Aid & Attendance with spouse and one dependent: maximum allowable pension is $26,766, with a monthly amount of $2,230
- Two veterans married to each other (both qualify for A&A): maximum allowable pension is $35,813, with a monthly amount of $2,984.
Veterans who meet the Basic Pension requirements and the clinical and financial requirements, can apply via this link.