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Should I look to Medicaid, VA benefits, or both, for my loved one's long-term care?

When your loved one needs long-term care, such as a nursing home, assisted living or care at home, government benefits may be helpful to those who qualify.  But which government program to turn to when your elder needs help? Obtaining VA Pension benefits (such as "Aid and Attendance") is different than planning for Medicaid benefits. 

One major rule is that we generally look for Medicaid benefits to pay for the nursing home while we generally look for VA assistance for in-home and assisted living care.  Why is this?

  • The nursing home is so very expensive that Medicaid is likely the best choice.  VA benefits (i.e., "Aid and Attendance") typically range between $1,000 to $2,000 per month, which is not nearly enough for the nursing home.
  • As VA benefits typically range between $1,000 to $2,000 per month, this is likely to be more helpful for assisted living costs. This page has the most current and common VA Pension levels
  • It is typically very difficult to get Medicaid to pay for assisted living or in-home care without a 60 day stay in the nursing home.

Applying for Medicaid or VA benefits can be difficult in the best of circumstances, often because you receive contradictory information and because the elder's health generally dictates the direction to proceed.  In looking for government help, the differences in asset protection options for Medicaid and VA benefits are highlighted in the below chart:                                                                                            

 

VA Pension Benefits

Medicaid Benefits

Asset Limit

Qualification is based upon life expectancy, spending rate and assets present. There are no set asset limits for qualification.

$2,000 for a single person

$120,900 for a married couple (2017)

Income limit

No real income limit exists as long as the applicant has high enough unreimbursed medical expenses.

$2,205/month in gross income (2017). If income exceeds this, a qualified income trust is needed.

Homestead

Not an asset for VA purposes but the sale of the homestead could be very bad.

Not an asset for Medicaid purposes; the sale of the homestead may be fine with the right planning.

Assisted Living benefits

VA benefits are available for ALF residents who need help with 2 activities of daily living.

Possible, although the elder may need a 60 day stay in the nursing home to access this benefit.

Need Attorney to Apply?

Generally, only if assets are exceeding the asset cap.

Definitely helpful in any situation due to the complexity of the application itself.

 

One more important aspect is that it is possible to get both Medicaid and VA benefits for in-home care or assisted living in certain situations, so these benefits are not mutually exclusive.

If your loved one needs long-term care, whether at home, in assisted living or nursing home, our office may be able to assist you and your loved one.

If you read this, you may want to read:

D. Rep DeLoach III
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Estate Planning and Board Certified Elder Law Attorney
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