How Medicaid and VA Benefits Work Together

 

Both the VA benefits and Medicaid can be used to pay for long-term care costs, but how they work together is often very confusing.

The Basics of VA Benefits

The VA benefit can be used to pay for home care, assisted living care, and nursing home care. It pays a set maximum amount to the wartime veteran or surviving spouse of a wartime veteran; currently the maximum ranges from $1,176-$1,830/month. The veteran (or surviving spouse) can then use this money to pay for the care that he/she needs. You can learn more about the Aid and Attendance Benefit here.

The Basics of Medicaid

Medicaid can be used to pay for long-term care expenses as well. In Georgia, Medicaid is mostly used to pay for long-term care in a nursing home, but Georgia does have some home and community based services that will provide in-home care or care in a personal care home (perhaps you have heard of our Elderly and Disabled Waiver Programs, or SOURC and CCSP). Our home and community based services have a long waiting list and other barriers to be used, so most Georgia Medicaid beneficiaries needing long-term services and supports receive care in a nursing home.

Dual Eligibility for Medicaid and VA Benefits

Can someone have both Medicaid and VA benefits? Yes! In fact, if a person is eligible for VA benefits, he/she must apply for them before applying for Medicaid. Medicaid wants to know that every eligible source of payment has been tried before applying for Medicaid. In such a situation, the VA benefits may be enough when added to existing income to pay for the total cost of the long-term care expenses in a nursing home, and the person may not need Medicaid. We have seen this happen for a few clients over the years. Unfortunately, since the VA benefits are capped at $1,176-$1,830/month, and since care can cost $8,000-10,000/month, the benefit is often not enough to pay for the total cost of care for most of our clients. This leaves many VA recipients still needing Medicaid to pay for nursing home care.

If a person is receiving VA Aid and Attendance Benefits, he/she may still be eligible for Medicaid. VA Aid and Attendance Benefits do not count as income for Medicaid purposes, so he/she may meet income eligibility criteria for Medicaid.

Once approved for Medicaid, though, the VA benefit is reduced to $90/month for most recipients. The exception to this reduction is: if the well spouse (or community spouse living somewhere other than a nursing home) has recurring, unreimbursed medical expenses. Since those expenses are counted when determining eligibility for the VA Aid and Attendance Benefits, there is a chance that the Aid and Attendance Benefits can be kept at a level above $90/month even if the wartime veteran is receiving Medicaid benefits in a nursing home.

Applying for Both Medicaid and VA Benefits

The VA and Medicaid have similar but distinct eligibility rules. Any asset protection planning that is done for VA Benefits must also consider Medicaid eligibility rules. Anyone seeking an asset plan to qualify for VA benefits must also consider Medicaid eligibility rules so that a person can access Medicaid later, if needed. The attorneys at Hurley Elder Care Law know the rules for both programs and help families navigate both systems.

The Medicaid and VA rules are complex, especially when they are combined. If you have questions or need more information, please contact Hurley Elder Care Law at (404) 843-0121.

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