Long-term care can be very expensive in Florida. Assisted living facilities can cost between $2,000 and $7,000 per month and nursing homes/skilled nursing can exceed $10,000 per month in Pinellas County. Very few people can afford these costs for a very long time. Luckily the government has a social safety net for our elderly and disabled population, which includes certain benefits for our veterans and his or her surviving spouse. The most popular government program to help with the elderly is the VA Pension program.
VA Pension (Aid and Attendance)
The VA Pension benefit program provides a monthly, tax-free, “needs based,” monetary payment for:
1. Low-income veterans with wartime service. (Veteran’s Pension)
2. The low-income, un-remarried surviving spouse and/or unmarried child(ren) of a deceased veteran with wartime service. (Survivor’s Pension)
- Are age 65 or older, or
- Show evidence of a permanent and total non-service-connected disability, or
- Reside as a patient in a nursing home, or
- Receive Social Security disability benefits.
Generally, the claimant would need assistance unreimbursed Medical expenses to get the highest level of pension. Other requirements are that the veteran must meet wartime service requirements, be financially eligible and able to meet an asset (net worth) and income test, and have been discharged for a cause other than dishonorable.
Wartime service is defined as having served at least ninety days of active military duty with at least one day served during a time of armed conflict in the following:
World War II: Dec. 7, 1941 – Dec. 31, 1946
Korean conflict: June 27, 1950 – Jan. 31, 1955
Vietnam era: Feb. 28, 1961 – May 7, 1975
(for Veterans who served in the Republic of Vietnam before official start)
Vietnam otherwise: August 5, 1964 – May 7, 1975
Gulf War: August 2, 1990 – (undetermined future date)
Veterans who began active duty after September 7, 1980, are required to have at least 24 months of active duty service, or, if less than that, to have completed his/her entire tour of active duty.
VA Benefits for your Elder
The big picture is that VA pension benefits can help needy veterans and their surviving spouse with the high costs of medical, including long-term care. The highest level of pension, known as “aid and attendance,” can provide cash benefits of up to the following amount per month (2021):
- Single Veteran $1,936/month
- Married Veteran $2,295/month
- Surviving Spouse $1,244/month
Pension is “Needs-Based”
Applying for a VA pension to assist with your loved one’s long-term care can be a very daunting process. Countable assets are taken into account. Veterans and spouses are allowed to own some $130,773 (2021) in countable assets, although this can vary a little based on the applicant's annual income.
Recent Changes to VA Pension Benefits
As of October 18, 2018, the VA finally announced sweeping changes to the Pension program. The VA was working on changes for years and it was good to see the changes finally come together in an order fashion. The changes for VA pension benefits can generally be summarized as follows:
- Three year look-back period: Those applying for VA Pension benefits must not have made uncompensated transfers within 3 years of applying for benefits. If assets are given away, a transfer penalty applies. Up until now, the VA did not have a transfer penalty. We have more information on the VA Pension transfer penalty here.
- Countable asset limit clearly defined at the Community Spouse Resource Allowance: This amount is now the $130,773 (2021), which will likely increase annually. A veteran, whether married or single, can now have $130,773 in countable assets and be eligible for VA pension benefits. This is similar to the amount of countable assets that can be owned under the Florida Medicaid rules. The $130,773 exemption can vary a little if the applicant's annual income exceeds his or her unreimbursed medical expenses.
- Homes are Exempt, with Exceptions: The value of the home does not matter for benefits purposes, but if the home has more than 2 acres, then this will be a countable asset, with certain exceptions.
The VA has provided some pretty good web pages that discusses these rules.
VA Pension Benefits can Help for Assisted Living Facilities
One of the best uses for VA Pension benefits (including aid and attendance) is to help with the high cost of assisted living care. We have more information on VA Pension benefits and other requirements that may assist you further.
Irrevocable Trusts for VA Benefits
If the elder wants to protect assets from the nursing home and also try to get VA benefits in the future, the family may consider creating an irrevocable trust for the veteran's assets, including the veteran's homestead property.
VA v. Medicaid for the Elderly
When helping an elderly loved one deal with long-term care issues, families will often get conflicting and confusing information about Medicaid and VA benefits. Your loved one can have both VA and Medicaid benefits, but there are a lot of potential problems in getting both. For the most part, we generally look to the VA to help pay assisted living and in-home costs and to Medicaid to pay for the high cost of nursing home care.
Pension for Medical Costs
Pension benefits are basically used to reimburse the applicant for medical costs. This includes doctors, nurses, drug bills, etc. It also includes non-licensed, in-home attendants if the care recipient is rated for the "aid and attendance" level and needs custodial care. Custodial care means help with two or more activities of daily living (ADLs), which are
- bathing or showering
- eating (feeding)
- toileting or transferring
- ambulation within home or area
Custodial care can also mean necessary supervision because an individual has a cognitive disorder (such as dementia) that protects the applicant from hazards or dangers in their daily environment.
You may also want to read:
Getting VA benefits for your loved one can be very difficult. We have some more articles that may help assist you in the decision making process: