VA Aid and Attendance Benefits

The Aid and Attendance Benefits program was established by Congress through the United States Department of Veteran’s Affairs and provides medical support to certain qualified veterans and their spouses.

Funds from the Aid and Attendance program can be used to help pay for:

  • Assisted living
  • Long term or nursing home care
  • Home health care
  • Other ongoing medical expenses

In order to qualify for Aid and Attendance Benefits, a veteran must be:

  • At least 65 or older
  • Have served on active duty at least 90 consecutive days
  • Have served at least one day during a period of war
  • Received a discharge other than dishonorable
  • Single surviving spouses of such veterans are also eligible

Qualifying war times are outlined below:

Period of War Beginning and Ending Dates
World War II December 7, 1941 through December 31, 1946
Korean Conflict June 27, 1950 through January 31, 1955
Vietnam Era August 5, 1964 through May 7, 1975; for veterans who served “in country” before August 5, 1964, February 28, 1961 through May 7, 1975
Gulf War August 2, 1990 through a date to be set by law or Presidential Proclamation

The veteran household cannot have income and assets that exceed the Community Spouse Resource Allowance amount for Medicaid ($126,420 in 2019). This number is increased by the same amount as the Social Security Benefit increase each year. At the time of the application, the household assets and income are added together to determine eligibility. If there are unreimbursed medical expenses that exceed the household income, the income is reduced to zero and only the assets are used to determine financial eligibility.

In October 2018, the VA implemented new rules for qualifying for the Aid and Attendance Benefit. These new rules have had both positive and negative impacts on the application and approval process.

Allowable medical expenses are described as ‘those that are medically necessary; that improve a disabled individual’s functioning; or that prevent, slow, or ease an individual’s functional decline.’ Below is a non-exhaustive list of allowable costs for unreimbursed medical expenses:

  • Recurring prescription drug costs
  • Prescribed, medically necessary food, vitamins, and supplements
  • Home health care, including allowable payments to family caregivers
  • Payments to care facilities, including room and board payments for certain, qualifying facilities
  • Service animal payments
  • Transportation for healthcare purposes

Additional qualifying factors that must be met pertain to the medical needs of the individual applying. In order to qualify for Aid and Attendance Benefits the individual must need help with at least 2 activities of daily living, commonly known as ADLs.

There are six basic ADLs:

  1. Eating
  2. Bathing
  3. Dressing
  4. Toileting
  5. Transferring
  6. Continence

However, the VA now accepts one additional ADL; ‘ambulating within the home or living area.’ This additional ADL may make it easier for certain applicants to qualify for the benefit.

The final test an applicant must pass before qualifying for the Aid and Attendance program is the asset test. If the household income is reduced to zero due to unreimbursed medical expenses, the household assets cannot exceed $126,420 in 2019. The VA does not consider the home, household vehicles, prepaid burial plots, household items and personal property, or irrevocable trusts established for a disabled child who was incapable of self-support prior to the age of 18, to be assets when applying for the benefit.

Dealing with Assets That May Disqualify the Applicant

Prior to October 2018 it was possible, using trusts and other strategies, to protect assets and qualify an individual for the Aid and Attendance benefit. However, the VA has since implemented a 3-year lookback period. Any gifts made in the 3 years prior to the application will result in a disqualification period. This disqualification period is determined by the value of the transfer divided by the maximum amount of benefit (currently $2,230). This means that a transfer of $6,690 will result in a 3-month penalty. The maximum length of the penalty is 5 years.

While the rule changes have altered the way in which we approach the Aid and Attendance Benefit program, it has provided more clarity and certainty in the application and approval process. If you would like to learn more about this or other programs designed to help aging individuals, please contact us today.

Practice Areas

Navigating the needs and complexities surrounding the older and aging population…
Guardianship, conservatorship, trust administration, and probating an estate.
Planning for an individual or loved one's incapacity or death
Future financial, life management, and medical care for those with disabilities.

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