How To Pay For Long Term and Nursing Home Care

Paying For Long Term Care Through Medicaid and VA Pensions

There are two primary public benefits programs that can help pay for nursing home or long-term care:  VA Pension and Medicaid (there is another VA program for veterans with a service-connected disability). 

Both programs have strict requirements for qualification and they are, to put it mildly, complicated.

What is a VA Pension and How Is A Veteran Eligible?

VA Pension is a federal program. It is available to veterans whose discharge is a type other than dishonorable, who served 90 days or more of active duty with at least one day during an Eligible Wartime Period, who have a disability, and who have a Net Worth of less than $127,061.  

For the disability part, the Veteran must be at least 65 years old, be permanently and total disabled, be in a nursing home because of a mental or physical disability, have limited eyesight, or be receiving SSDI or SSI.

The benefit is also available to a Veteran’s surviving spouse, provided he or she has not remarried. 

The Net Worth requirements changed considerably on October 18, 2018.  Under the prior rules, a veteran could lower his net worth by transferring his or her assets to someone else any time before applying for the program.  Under the new rules, the VA will “look back” at any transfers that occurred for the 33 years prior to the veteran’s benefit application. Those transfers will count against the veteran.

It is difficult for a veteran to get help preparing and filing his claim because the VA requires that individuals who would help a veteran first be accredited by the VA, and prohibits the individual from receiving money from the veteran for providing help.  

For more information about the VA Pension program, visit your local veteran’s affairs office or look online at https://www.va.gov/pension/.

How To You Know If You Are Eligible For Medicaid

Medicaid is a joint federal-state program.  Every state imposes its own rules for the program.  Medicaid can provide for care in a nursing home or ICF-IID facility or at home under its Home and Community Based Services.  Many people are termed “dual eligible,” meaning that they are eligible for both Medicare and Medicaid.  

A person is eligible for Medicaid long-term care if he or she is at least 21 yrsyrs. old, has a medical necessity for nursing home care, has limited income and resources,  (the amount depends on whether the person is married or not), and is a U.S. citizen or U.S. national or a qualified alien.  

Medicaid has a 5-year look-back period for transfers and a transfer may disqualify you from benefits.  The government has a right to make a claim in your probate estate to get reimbursed for money it pays out for your benefit.  Most people do advance Medicaid planning so that they can qualify and their estate can avoid the government pay-back (known as MERP).

It is much easier to get assistance to file a Medicaid claim.  The law permits any licensed attorney to help, and the attorney is allowed to collect fees for the services.

Long-term care is so expensive that every family should consider all available options.

Virginia, a SMU law school graduate, has advised clients for over 35 years.  For more information, visit hammerle.com, and for newsletter sign-up, email legaltalktexas@hammerle.com.  This column does not constitute legal advice.