The Veterans Administration (VA) has special programs that provide veterans and their widowed spouses with supplemental income that can help cover the costs associated with long-term care such as assisted living, home care, adult day services, or nursing care. This type of senior veterans medical benefit is known as Aid and Attendance, or A & A. But not everyone knows this benefit is available – in fact, only about 5 percent of qualified veterans are receiving it.
Here’s what you need to know.
- What Is Aid and Attendance?
- Medical Criteria
- Financial Criteria
- Service Criteria
- Benefit Amounts
- How to Apply
- Denials and Reapplication
What Is Aid and Attendance?
Aid and Attendance is a nonservice-related tax-free pension paid monthly for the rest of the veteran’s or his/her dependent’s life. It is a direct-deposit to your account.
“Aid and Attendance is intended to provide financial support to veterans and their loved ones to help reduce the cost of care in a senior living community,” says Abigail Anderson of Patriot Angels, an organization that assists veterans in navigating the complicated benefits application process. If the necessary care is in place, A & A can be used to offset the cost of room and board in an assisted or independent living community. It can also help offset the cost of a third-party care provider in a community or at your home.
You must meet certain medical, financial and service requirements to qualify.
According to the VA, if you meet one or more of the following medical criteria, you could receive A & A benefits:
• You require the aid of another person to perform activities of daily living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices or protecting yourself from the hazards of your daily environment.
• You’re bedridden, which means that your disability requires you to remain in bed apart from any prescribed course of convalescence or treatment.
• You’re a patient in a nursing home due to mental or physical incapacity.
• Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes, or concentric contraction of the visual field to 5 degrees or less.
You may qualify for the Housebound benefit if you’re substantially confined to your immediate residence due to a permanent disability. It’s important to note that you cannot receive both the A & A and Housebound benefits at the same time.
The VA looks at your assets and countable income to determine your financial eligibility. Countable income can include pension payments, disability payments, and interest and dividends from investments. Both assets and expenses are considered when determining eligibility. “They make a calculation set by stature to determine how much income should suffice for your care,” said Anderson.
Anderson is quick to point out that you shouldn’t assume you won’t be eligible. “A lot of people look at that income amount and automatically disqualify themselves because they see they are above the threshold. But keep in mind if you’re currently receiving care, you could be spending enough of your income to actually qualify for aid.”
You can also talk with a VA-accredited lawyer about estate planning, and setting up an irrevocable trust to help reduce the amount of income while protecting your finances for the future.
Receiving a disability pension (a service-connected pension) can affect your eligibility as well. Depending on your disability rating, you could be rated higher than the maximum amount of A & A, and therefore would be considered ineligible for a non-service connected pension.
“Getting approval for disability benefits can take up to two years,” says Anderson, “so some people apply for and receive A & A benefits while they’re waiting for their rating and approval.”
Those who receive a VA pension must meet minimum duty requirements. You must have served at least 90 days of active duty, with one of those days having been during a period of active war. And you must have received a general, honorable or medical discharge.
Eligible wartime periods are:
• Mexican Border Period (May 9, 1916 – April 5, 1917 for veterans who served in Mexico, on its borders, or adjacent waters)
• World War I (April 6, 1917 – November 11, 1918)
• 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 law or Presidential Proclamation)
Determining eligibility can be tricky and time-consuming. To make it easier, download these additional resources before starting the application process.
Payments are disbursed directly to you, and how much you receive every month will vary based on your counted income, number of dependents, assets and expenses. In 2016, the maximum annual A & A pension rates were:
• $21,531 for a veteran
• $25,525 for a veteran with one dependent
• $13,836 for surviving spouse of a qualified veteran
How to Apply
There are two direct ways to apply for A & A or Housebound benefits.
• Through the Pension Management Center (PMC) that serves your state
• Through your local regional office to file
No matter how you apply, here’s what you need to do to get started:
Step One: Gather financial information about your income and net worth, medical records, and a written doctor’s report verifying the need for aid and attendance.
Step Two: Once you have that information, it’s time to submit your intent to file through one of the regional offices. You will receive a letter from the VA with a file number, which means you have officially opened a claim.
Step Three: This is actually a series of steps involving a lot of paperwork and communication with the VA. From the time of your initial submission, the VA typically takes 10-12 months to review your information and either approve or deny your claim. It’s recommended you send all information via Certified Mail Return Receipt so you have verification that it’s actually been received. Be sure to keep a copy of your application and all VA correspondence for your own records.
Denials and Reapplication
“Don’t underestimate the complexity of the process,” says Anderson. “Even if you have been prequalified and know that you’re eligible, that doesn’t make the process any easier. You still must apply and wait for approval. If one T isn’t crossed or one I isn’t dotted, the administration can deny you.”
If you receive a hard denial, you may not be able to reapply for an additional 12 months. “This is a bind that a lot of families find themselves in,” Anderson says, “a bind that could have been prevented had they been given the right assistance.”
Seeking the advice of VA-accredited lawyers or a service such as Patriot Angels can help you determine your eligibility and help you navigate the process to receive the benefits you’ve earned.
Free Veteran Benefit Review
The Sanctuary at West St. Paul offers this service to veterans and their families. Call 1-855-806-0533 to learn more.
Content courtesy of Where You Live Matters by American Seniors Housing Association. Sources:
• Veterans Benefits Administration
• Patriot Angels
• Paying for Senior Care