Nursing Home Medicaid for Married Couples—What if we already get VA Benefits?

The Aid and Attendance Benefit offered to wartime veterans is often used to pay for assisted living care or home care (https://hurleyeclaw.com/practice-areas/veterans-aid-attendance/). What if a couple is living in an assisted living community and receiving the VA Aid and Attendance Benefits when nursing home care is needed for the wartime veteran?

In a situation like this, the couple is still eligible to receive the VA Aid and Attendance Benefits. Nursing home care is a medical expense, and a nursing home resident is eligible to receive VA Aid and Attendance Benefits (assuming all other eligibility requirements are met). Unfortunately, since the VA benefits are capped (for a married couple in 2017, that cap is $2,127/month), it does not supplement most couples’ income enough to cover the cost of care. Most nursing homes cost over $8,000/month; so a couple would need significant monthly income in addition to the $2,127 to afford both assisted living care for one spouse and nursing home care for the other spouse.

Couples in similar circumstances have turned to Medicaid to pay the nursing home costs. Even if you are receiving VA Aid and Attendance Benefits, you may still be eligible for Medicaid. VA Aid and Attendance Benefits do not count as income for Medicaid purposes, but benefit will be reduced to $90/month for most recipients. That is, the benefit is usually reduced to $90/month UNLESS the well spouse (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. The Medicaid and VA rules are complex, especially as they pertain to married couples. If you have questions or need more information, please contact us at (404) 843-0121.