Long Term Care Planning (VA and Medicaid)
Many of today’s senior citizens served either in World War II or in the Korean War. The aging Baby Boomer population served in Vietnam. We also have a generation of people who served in the Gulf War and who are returning from the wars in Iraq and Afghanistan. As other forms of public benefits become more difficult to access, Veteran’s benefits are increasingly becoming an important to help meet the financial and medical needs of the people who served our country.
Depending on a variety of factors (including when they served, their rank, and the type of discharge they received) Veterans are entitled to a host of different types of benefits: educational subsidies, special mortgages, cemetery plots. In an Elder Law practice, the veterans benefit addressed most often is the Veterans Administration (VA) improved pension benefit (simply called a pension in this article).
The use of the term “pension” is a bit of a misnomer. When most people think of a pension, they think about getting a monthly payment from their employer. An improved pension benefit is a need-based monthly payment made to eligible veterans. The amount of the pension a veteran receives will depend on the amount of that person’s monthly income (net of medical expenses) and the type of pension.
Currently, the VA offers three types of pension benefits: the basic pension, which pays a small monthly benefit; a Homebound pension, which pays a larger amount to individuals who cannot leave their homes without assistance; and Aid & Attendance, which pays the largest available benefit to individuals who require 24-hour care.
To be eligible for a VA pension, a veteran’s must meet the following criteria:
- The veteran must be totally and permanently disabled or over age 65 at the time of application.
- The veteran must have had a discharge other than “dishonorable.”
- The veteran must have served 90 or more consecutive days, at least one day of which was during a period of war. Individuals who joined the military after September 8, 1980 have additional service requirements.
- The individual must have limited income and net worth that is inadequate to meet his needs.
A lot of “mythology” exists around the VA pensions. There is a common myth that someone who earns more than $80,000 per year is automatically ineligible for VA benefits. Actually, benefits are determined by looking at the individual’s income and subtracting his medical expenses from that amount. The VA is required to take a certain action if the individual makes more than $80,000 annually, but it does not affect the veteran’s ability to receive the pension.
Similarly, some people believe that a veteran cannot own a house and be eligible for a VA pension. Again, this is not true. Houses are considered “exempt assets,” and the VA will not include the value of the veteran’s home in its determination.
An Improved Pension Benefit can help save a household struggling to meet its medical or assisted living expenses. A veteran or his surviving spouse who have some assets may still qualify for a pension benefit with appropriate planning. Please consult an accredited VA Attorney or VA agent with any questions you have about VA pensions.
What is Medicaid?
Medicaid is a need-based program primarily designed to pay for the medical care for people with limited income and assets. The program contains both federal and state components. The federal government creates the laws and regulations that provide the framework for Medicaid, and the states implement those regulations through their own sets laws and regulations. Funding for Medicaid comes from both the federal and state governments.
Most people don’t realize that the federal government created over 50 different types of Medicaid programs. The State of Georgia has implemented 36 of those programs. Generally speaking, there are four different types of Medicaid in Georgia:
- Aged, Blind and Disabled. These programs provide medical benefits to individuals who are over age 65, blind or disabled under the Social Security Administration regulations. The program most often seen in an Elder Law practice is Nursing Home Medicaid. In Nursing Home Medicaid, the Medicaid recipient pays her monthly income to the Nursing Home, and Medicaid pays the portion that she cannot afford. Once the recipient dies or no longer needs nursing home care, Medicaid recovers the money it spent on that person’s care through a process known as Estate Recovery.
- Qualified Medicare Beneficiary (QMB). Individuals in this program are eligible to receive Medicare benefits but have such a low income that they have difficulty making the monthly Medicare premiums. The QMB program pays the individual’s monthly Medicare premium, giving these individuals additional access to medical care.
- Family Medicaid. This program provides health care benefits for children and their families. The popular PeachCare for Kids program, a program that provides health insurance for children in Georgia, is a form of Family Medicaid.
- Waiver Programs. In the past, Medicaid benefits favored individuals in institutions. For example, it provided benefits for people in hospitals, nursing homes and in hospice. But what about those individuals who needed the same level of care of someone in a hospital or nursing home but who could receive care at home or in a group facility? In recognition that not all care must be provided in an institution and that it can be less expensive to care for someone at home, Medicaid created a series of waiver programs. These programs frequently provide more than medical care. They also provide services that help individuals maintain their independence, such as housing services, home health care, respite care, and even home delivered meals.
Medicaid is a complex program, and what is required to be eligible for Medicaid changes from program to program. An Elder Law attorney can help determine which program may assist you and your family and guide you through the requirements of that program.