Sykes Elder Law: How veterans benefits and Medicaid work together

Certified as an elder law attorney by the National Elder Law Foundation under authorization of the Pennsylvania Supreme Court

Certified as an elder law attorney by the National Elder Law Foundation under authorization of the Pennsylvania Supreme Court

(2010)As Veterans Day approaches, it is good to remember ways to honor those who served our country during wartime.

One way is with the benefits extended to those veterans, and their widows and widowers, who now need long term care.

How do those benefits intersect with Medicaid benefits for long term care?

Going from veterans benefits to Medicaid

Medicaid benefits cover those whose medical needs make them “nursing facility clinically eligible,” something akin to needing skilled nursing services. Those who apply for veterans benefits usually have a need for lesser services, such as home care, assisted living, or adult day care.

As a result, many recipients start out with veterans benefits when their care needs are modest, then apply for Medicaid later when care needs increase.

If a recipient of veterans benefits later qualifies for Medicaid, and has no spouse or other dependents, the veterans benefit drops to $90 per month.

If there is a spouse, both the “low income pension” and “aid and attendance” portions of the veterans benefits can continue, often to the financial advantage of the spouse. For example, a Medicaid recipient’s spouse is entitled to an income known as the “monthly maintenance needs allowance” or “MMNA.” The low income pension can be used to pay the spouse’s MMNA, if the couple otherwise has insufficient income.

Under Medicaid regulations, the aid and attendance portion is not considered “income” to the Medicaid recipient, and can be given to the recipient’s spouse in addition to the MMNA. Currently $716 per month, this extra income can often make quite a difference in a spouse’s quality of life.

Planning considerations

Many veterans with substantial assets are pleasantly surprised to learn that they can eventually qualify for benefits with the right advice and planning. (See more details on the veterans benefits page.)

But be careful! What works under the Veterans Administration rules to qualify may cause a problem with Medicaid qualification a few years down the road. It’s important to take steps to help ensure that an applicant can qualify for both sets of benefits if necessary.

An elder law attorney accredited by the VA can help you do the right planning.

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