November 22, 2009
What Is the Veterans Aid and Attendance Pension Benefit?
”Aid and attendance” is a commonly used term for a little-known veterans’ disability income. The official title of this benefit is “Pension.” The reason for using “aid and attendance” to refer to Pension is that many veterans or their single surviving spouses can become eligible if they have a regular need for the aid and attendance of a caregiver or if they are housebound. Evidence of this need for care must be certified by VA as a “rating.” With a rating, certain veterans or their surviving spouses can now qualify for Pension.
The purpose of this benefit is to provide supplemental income to disabled or older veterans who have a low income or high medical costs. Pension is for war veterans who have disabilities that are not connected to their active-duty service. Pension is primarily intended for very low income veterans, but a special provision in how Pension is calculated can allow veterans or single surviving spouses with high income to also receive the benefit which may be as much as $1, 949 a month. This special provision kicks in for veterans who have ongoing and expensive long term care costs.
Aid and Attendance Pension benefit can pay up to $1,949 a month for qualifying long term care needs such as:
- Family members who provide home care
- Professional home care providers to come into your home
- Assisted Living or Adult Day services
- Nursing Home long term care
- Home renovations for disability
- Prescription drug costs
- Insurance premiums
- Diabetic or incontinence supplies
- Other un-reimbursed medical expenses
If the veteran’s income exceeds the Pension amount, there is usually no award given, however, income can be adjusted for unreimbursed medical expenses, and this allows veterans with household incomes larger than the Pension amount to qualify for a monthly benefit. There is also an asset test to qualify for Pension.
If you have assets and a sizable income, you will most likely need and benefit from the services of a Veterans Benefits Consultant concerning what you need to do before you submit to the VA for an award. It is extremely important that assets that might be gifted or converted to income also meet Medicaid gifting rules in case the veteran or the surviving spouse may have to apply for Medicaid. The consultant can help avoid Medicaid penalties associated with reallocating assets.
Angela N. Manz is a veteran’s benefits consultant who understands the aid and attendance benefit as well as Medicaid rules. Angela N. Manz can be reached at 757-271-6275 or by going to www.manzlawfirm.com
November 15, 2009
Average Cost of a Nursing Home Inches Closer to $80,000 a Year
Although the US economy has seen price rollbacks during the last year, long-term care providers have actually been raising rates, according to the 2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs. Private room nursing home rates rose 3.3 percent to an average of $79,935 a year or $219 a day, while assisted living also climbed 3.3 percent on average to $37,572 a year or $3,131 a month.
Home health care aides now cost an average of $21 per hour, which represents a 5 percent jump, and adult day care services now average $67 per day, a 4.7 percent increase over 2008.
The MetLife survey also reports on the cost of a semi-private room in a nursing home, which increased 4 percent to $198 a day, or $72,270 a year. The cost of a semi-private room in an Alzheimer’s or Memory-Care wing averages $75,920 annually.
Once again, the highest rates for a private nursing home room in 2009 were found in Alaska, where the cost is $584 a day on average. The lowest rates were found in Louisiana (with the exception of Baton Rouge and the Shreveport area), at $132 a day.
The cost of assisted living was the highest in Wilmington, Delaware, at $5,219 a month and the lowest in North Dakota at $2,014 a month. Home health care aide services ranged from a high of $30 an hour in Rochester, Minnesota, to $13 and hour in the Shreveport area. Adult day care services were highest in Vermont at an average $150 a day and lowest in the Montgomery, Alabama, area, at $27 a day.
For the full MetLife 2009 survey report, including the average long-term care costs for selected cities, please follow this link:
July 16, 2009
Will Medicaid Take My Home?
Medicaid and Medicare are two government programs available to seniors that can be very confusing. Medicaid is a federal government program, administered through the states, that will cover almost every expense associated with nursing care for those who qualify. Medicare is a health insurance program for people over age 65 or for people under age 65 with certain disabilities.
Medicaid is frequently used for people who require full-time or skilled nursing care. In Virginia, Medicaid will provide benefits for a nursing home or for some limited in-home care service
The eligibility requirements for Medicaid are very strict and there can be significant penalties imposed for not following the rules. In Virginia, a single person can have no more than $2,000 in countable assets. For a married couple, the spouse applying for Medicaid may have no more than $2,000 and the spouse still living in the community may keep up to $109,560 in countable assets. This doesn’t mean that every community spouse may keep $109,560. It means that this is the maximum in countable resources that the community spouse is allowed. The rules on how to calculate the amount that a community spouse may keep depend on what assets the couple has when the institutionalized spouse enters the hospital or nursing home. Also, not every asset is countable for Medicaid purposes. For instance, an individual applying for Medicaid is allowed to have one personal vehicle as an exempt asset.
The biggest question I get is whether Medicaid will take your home. I frequently find that there is a lot of misinformation on this subject as well, so we will clear that up here today. In Virginia, Medicaid does not “take” anything from anyone. What happens is that the assets of the couple (or individual, if not married) are looked at as of the date that the ill spouse (or single individual) first entered the hospital or nursing home for a period of thirty days or longer. This is called the “snapshot date”. If the couple (or single individual) has too much in countable resources, they will be required to spend those excess resources before becoming eligible for Medicaid. This is called “spending down”. Once those extra assets are spent down, they can then apply for Medicaid. The good news is that, for a married couple, as long as the community spouse remains in the home, it is NOT a countable resource and is not counted for Medicaid purposes. For a single person, the home is exempt for the first six months, but after that a “good faith effort to sell” must be made. This does not mean that the person must actually sell their home before getting Medicaid. This is where people can get themselves into trouble, so it would wise to seek counsel from an elder law attorney before attempting this on your own.
Each week I hear stories from my clients about advice and ideas that they get from others. Most of the time the information is either incorrect or is not correct for that person’s situation. It is imperative that you discuss your individual situation with an elder law attorney. You need someone who can look at all pieces of the puzzle and give you accurate advice to create a long-term care plan that works for your family. Don’t rely on third-hand information. Going straight to a professional will save you time, money and heartache in the future.
This blog post is not intended to provide legal counsel or to be a substitute for legal counsel. We assume no responsibility for any errors, omissions or any damage resulting from the use of this information.
Ten Warning Signs Your Senior Loved One May Need Help
Ten Warning Signs Your Senior Loved One May Need Help
For many Americans, it can be difficult to determine when a senior loved one needs help.
Has your family member:
- Changed eating habits, has no appetite, or missed meals
- Neglected his or her personal hygiene
- Neglected his or her home so it is not as clean or sanitary as usual
- Exhibited inappropriate behavior by being unusually loud or quiet, paranoid, agitated, or making phone calls at all hours
- Changed relationship patterns with friends and loved ones
- Had physical problems, weakness, forgetfulness, or possible misuse of alcohol or prescribed medications, or is forgetting to take medications
- Decreased or stopped participating in activities that were previously important
- Exhibited forgetfulness resulting in unopened mail, piling newspapers, not filling his or her prescriptions, or missed appointments
- Mishandled finances such as not paying bills, losing money, paying bills twice or more, or hiding money
- Made unusual purchases such as buying more than one magazine subscription of the same magazine, entered an unusual amount of contests, or increased the usage of purchases from television advertisements
If your loved one exhibits one or more of the behaviors listed below, it may indicate that action should be taken. You should contact the senior’s primary care physician and schedule an appointment to discuss the changes you have observed. It would also be a good time to consult with an elder law attorney to ensure that your loved one has a long-term care plan in place.
The first step in preparing a long-term care plan involves reviewing the senior’s estate plan. If your loved one does not have a power of attorney and advance medical directive in place, now is the time to complete this important task. If you wait too long, your loved one may no longer have capacity to complete their estate planning and require you to obtain a guardianship through the court system in order to assist them with their on-going needs.
The second step in creating a long-term care plan involves discussing the senior’s current living situation and determining whether it will remain a safe situation for that senior. If it is not a safe situation, you should determine whether the senior requires some in-home care or whether it would be better for them to move into an assisted living community or a nursing home.
Finally, the long-term plan must include a determination on how the senior can pay for the help they need without exhausting their assets too quickly. An elder law attorney will help you decide whether Medicare, Veteran’s benefits, Medicaid, or other benefits might be available to the senior and how to properly apply for those benefits.
One thing to remember is that you should not wait too long to prepare a long-term care plan with your loved one. The earlier that planning takes place, the easier things will be when a crisis occurs. Proper planning prior makes all the difference.
This blog post is not intended to provide legal counsel or to be a substitute for legal counsel. We assume no responsibility for any errors, omissions or any damage resulting from the use of this information.
