It was about 2 years ago that I became aware that my parents were financially somewhat destitute. By this I mean that their savings is completely gone. They don’t own their home. They receive my dad’s pension in addition to Social Security so they’re better off than some.
About 6 months ago or so my sister and I realized that Mom couldn’t take care of Dad anymore without assistance. Dad had a couple of falls. He didn’t break anything but was very sore and shaky for a long time afterward. Mom was helping him shower which we felt was dangerous because she is a full foot shorter than him and has knee and back and feet trouble herself. Also the big tell was that Mom started talking about moving into an assisted living facility (ALF). I won’t go into that because it ended up being off the table after Dad had the stroke and broke his hip in July (in order to live at the ALF they were considering, you have to be able to evacuate the building on your own power in case of a fire). The relevant point is that when we were considering the ALF versus in-home assistance, we looked at applying for a Veterans Administration (VA) pension. Dad is a Korean War veteran.
There is an excellent website that explains how the VA pension works. It is the Senior Veterans Service Alliance. The page about the “aid and attendance” benefit is here. This site lays things out clearly with examples. The bottom line is that in 2016 the VA will make sure that a veteran with a dependent spouse will not have to live on less than $25,448 per year after qualified regularly occurring medical and personal care expenses (minus an $842 deductible). However the maximum VA aid and attendance benefit is $25,448 (minus the deductible).
This does NOT mean (as an expensive elder law lawyer and a doctor-assigned care coordinator suggested to us) that the VA will pay $25,448 per year on your medical expenses. What is does mean is that for example if your income is $51,000 per year and you spend $30,000 on regular qualified expenses (showering assistance, companion care, meals, housecleaning, physical therapy, health insurance premiums), causing your net income to fall to $21,000, then the VA will pick up $3,606 of those costs (raising your net income to $25,448 minus the $842 deductible).
Alternatively, if you live in an ALF, then all of those costs for the veteran are qualified costs (I’m not certain about the spouse: some of my sources say yes they are qualified, others say only the portion of ALF costs that constitute medical care vs. room & board qualify for the spouse). The ALF that my parents were considering costs $72,000 per year for the two of them, and their health insurance premiums are $11,000 per year. For the sake of argument, let’s say all of the ALF costs were considered to qualify and our couple has an income of $51,000. In this case, the couple needs $32,000 more in order to pay for the ALF and their premiums. The VA will pitch in $25,448 – $842. So the couple still needs to come up with $7,394 to be able to live in the ALF. Plus additional money to pay for car insurance, phone, etc.
Each state has Veterans Service Officers assigned to regions to help you navigate this stuff. They know how to fill out the forms and advise you. I met once with the officer in my parents’ area when we were considering in-home help. I never met with him to talk about specifically about the ALF scenario because our situation changed before we got to that point.
VA benefits will not pay for living in a nursing home.
Update 10/25/2016: The above statement that “VA benefits will not pay for living in a nursing home” is not accurate. It is true that VA benefits do not apply for single people eligible for Medicaid. In our situation, where Dad is a veteran eligible for Medicaid for help with his nursing home costs and Mom is his spouse not in a nursing home, it isn’t totally clear what VA will do and how income from a VA pension would affect the amount of Medicaid assistance he receives. Our VA service officer is unable to predict how this will turn out, but we’ve started the process of applying for VA benefits. The Senior Veterans Service Alliance discusses this topic here. I will post more about this topic when we see how things turn out.
myagingparents 