Aid & Attendance for Veterans and Spouses
The VA offers Aid and Attendance benefits to wartime veterans and surviving spouses of wartime vets which can help pay for long-term care provided in the home, in an assisted living facility or a skilled nursing home. Effective December 1, 2014, the benefit can pay up to $2,120 per month for a married veteran and $1,789 for a single veteran or a married veteran with a sick spouse. Additionally, if the veteran has a surviving spouse who has not remarried, the survivor can receive up to $1,149 per month of Aid and Attendance.
VA Aid and Attendance Eligibility
To receive Aid and Attendance the veteran does not need to have a service-related injury. However, as provided below, the veteran must have qualifying military service and the veteran or single surviving spouse (“claimant”) applying for the benefit must satisfy medical, low-income and net worth requirements.
Qualifying Military Service for Aid & Attendance
In order to have “qualifying military service” for VA Aid & Attendance, the veteran must:
- Have been discharged under other than dishonorable conditions;
- Have at least ninety (90) consecutive days of active military service; and
- Have served during a Period of War.
Periods of War:
- WWII. December 7, 1941 – December 31, 1946. If Veteran was in service on December 31, 1946, continuous service before July 26, 1947 is considered WWII service.
- Korea. June 27, 1950 – January 31, 1955.
- Vietnam. February 28, 1961 – May 7, 1975 if served in the Republic of Vietnam. August 5, 1964 – May 7, 1975 if did not serve in the Republic of Vietnam.
- Gulf War. August 2, 1990 to a date to be determined.
Importantly, service combat is not required.
Medical Requirement for Aid & Attendance
Before a veteran, spouse or single surviving spouse can receive Aid & Attendance, he or she must meet one of the following conditions:
- Require the regular assistance of another person to perform everyday tasks, such as the following: preparing meals; eating; bathing; dressing; toileting; taking medications adjusting prosthetic devices; or protecting against the hazards of his or her daily living environment.
- Bedridden, apart from any prescribed course of treatment or therapy.
- Patient in a nursing home due to mental or physical incapacity.
- Vision is limited to corrected visual acuity of 5/200 or, less in both eyes, or concentric contraction of the visual field to 5 degrees or less.
Financial Eligibility for VA Aid & Attendance
If the veteran has qualifying military service and the claimant is in need of regular aid and attendance, it is important to determine whether or not the claimant satisfies the VA’s low-income and net worth requirements.
Low-Income Requirements for Aid & Attendance
To receive Aid & Attendance, the claimant’s household countable income must be below the VA’s Maximum Annual Pension Rate (MAPR) for the applicable MAPR category. Countable income is all income received (not including SSI payments), MINUS unreimbursed medical expenses exceeding 5% of the applicable basic pension MAPR.
What is the VA Aid & Attendance MAPR for 2017?
| 2017 Aid and Attendance Maximum Annual Pension Rate (MAPR) Category If you are a … |
5% of Basic Pension MAPR (The amount you subtract from medical expenses …) |
Annual Aid and Attendance Pension Rate Your yearly income must be less than … |
Single Veteran | $645 ($54 per month) |
$21,531 ($1,794 per month) |
| Veteran with Spouse/ Dependent |
$842 ($70 per month) |
$25,525 ($2,120 per month) |
| Surviving Spouse | $433 ($36 per month) |
$14,397 ($1,200 per month) |
Where can I find a complete list of deductible unreimbursed medical expenses?
Unreimbursed medical expenses include: cost of in-home care, assisted living, or nursing home; private caregivers; health related insurance premiums (including Medicare premiums) and copayments; medical supplies; incontinence supplies; prescriptions; prescription glasses; and dentist’s fees. Unreimbursed medical expenses can only be deducted to the extent they exceed 5% of the applicable basic pension MAPR. See 38 CFR § 3.272(g).
How do you calculate how much Aid & Attendance pension an eligible claimant will receive?
After subtracting the claimant’s deductible household medical expenses from the claimant’s household income, if the resulting “Income for VA Purposes” or (“IVAP”) is $0 or less, the claimant may receive the full applicable Aid and Attendance pension rate. For every IVAP dollar in excess of $0, the applicable Aid and Attendance pension rate is reduced by a dollar.
Net Worth Requirements for Aid & Attendance
In addition to low-income, VA claimants must also have limited net worth. Unlike most benefit programs, the VA does not have a specifically defined “net worth” limit. The VA considers the claimant’s net worth and the “all the circumstances” such as household income and how much should “reasonably” be consumed for the claimant’s maintenance. In considering how much should be consumed for the claimant’s maintenance, the VA evaluates: whether property can be readily converted to cash at no substantial sacrifice; life expectancy; the number of dependent family members; and the potential rate of depletion including unusual medical expenses.
Many VA accredited professionals advise that if the VA claimant is a single veteran or the surviving spouse of a deceased veteran, the claimant’s net worth should be less than $50,000. If the veteran is married, the couple’s combined net worth should not exceed $80,000. Because the net worth limit is subjectively determined by the VA on a case-by-case basis, we generally recommend a net worth of no more than $30,000 for a single claimant and no more than $60,000 for a married couple.
How do you calculate net worth for purposes of VA Aid and Attendance eligibility?
The VA, pursuant to 38 CFR § 3.275 defines “net worth” to mean the market value, less mortgages or other encumbrances, of all real and personal property owned by the claimant, except the claimant’s single-family residence, including a reasonable lot area, and personal effects suitable to and consistent with the claimant’s reasonable mode of life.
What can we do to get below the VA’s net worth limit?
Several options exist for reducing the VA claimant’s net worth, including: buying a preneed funeral plan; paying down unsecured debt; paying down secured debt on assets that are excluded from VA calculation of net worth; making improvements to the claimant’s dwelling; buying an immediate annuity; and gifting assets, along with all incidents of ownership and control in the assets, to someone other than a relative residing in the claimant’s household. While several strategies exist, you need the guidance of an experienced elder law attorney as every case is unique and serious adverse consequences could result without qualified counsel.
Can we rent or sell the claimant’s home and still receive Aid and Attendance pension benefits?
Probably not. If the claimant’s home is leased, the net income will count against the claimant. Moreover, if the house is leased it is no longer considered an excluded dwelling for calculating the claimant’s net worth. The home would be considered a countable investment property. Therefore, other arrangements need to be made with respect to the claimant’s home. Such planning should ideally occur before filing a claim for Aid and Attendance.
VA Aid and Attendance Planning
If the claimant does not currently meet the low-income and net worth requirements for Aid and Attendance benefits, The Hale Law Firm can help. Our VA accredited attorneys provide pre-filing eligibility and asset protection services as part of our overall long-term care planning. These services typically include:
- Senior Housing Decisions
- Advance Directives for Health Care Decision-Making
- Planning for Property Management in Event of Incapacity
- VA Benefit Trusts
- Medicaid Planning
Only VA accredited agents and attorneys can receive fees for VA Aid & Attendance Planning. However, under federal law, no-one (not even a VA accredited attorney) can receive a fee for filling out or filing a claim with the VA once a claim has been made.
Care should be taken to avoid financial consultants who offer to provide assistance with filing a VA claim. Home health and assisted living facilities often refer veterans and their families to financial consultants to obtain VA benefits. While these financial consultants may offer to file a VA claim for free, they earn commissions on the sale of financial products that are generally unsuitable for VA claimants. Before you engage in any VA planning that involves purchasing an annuity, gifting (whether outright or in trust), or compensating a family member for providing aid and attendant services, you should contact a VA accredited attorney with extensive experience in Medicaid Planning to avoid serious adverse Medicaid and tax consequences.