A & A and Medicaid

[jbryant916]

We are beginning the process to apply for A&A for my mother-in-law.  Right now, she is paying to live in an assisted living facility from her own resources.  By the family's calculations, she will literally be out of money in about 9 months, and we are also preparing an application for Medicaid.  My question:  If she should be approved for A&A, and then subsequently goes on Medicaid, will the A&A benefit continue to be paid directly to her?  (A&A and her Social Security benefits combined would not cover her monthly expenses).

Thanks much for any insight on this.  If the A&A would have to be forfeited/surrendered because she was on Medicaid, we're wondering if we should even bother with the A&A application, given the time required to process the claim.  Thanks again.

[vetadmin]

Medicaid laws vary from state to state; however, if you file for Medicaid the most that would be awarded in A&A benefits would be $90.00.  For Medicaid purposes, the $90.00 cannot go towards medical expenses, and needs to be spent on personal items.

[jbryant916]

Thanks much.  That's kind of what we were thinking.  OK, we can make a decision as to whether to apply with that information.  Although, $90 bucks is $90 bucks....

[vetadmin]

Yes it is, and in this economy even more so.

[AngelaManz]

Aid and Attendance isn't paid in full if someone is in a nursing home.  When that happens, only $90 per month is paid.  But Medicaid doesn't typically pay for assisted living.  In Virginia, there is a small auxillary grant that can help with assisted living costs, but it's hard to obtain and very small.  So if your mother-in-law stays in assisted living, with some kind of Medicaid grant benefit coming in but not paying the full amount of her care, then she could potentially keep the full A&A amount (since assisted living is not a nursing home).  However, if Medicaid is paying for all of her care, then she would not be able to keep the full benefit.

[VSR]

Its also worth noting that the $90 rate does not apply to vet's with dependents or vets in veterans homes, even if they are covered by Medicaid. I'm pretty sure it also doesn't apply if they have Hanson's disease (leprosy)

[AngelaManz]

I'm pretty sure it also doesn't apply if they have Hanson's disease (leprosy)

I thought I had heard it all, but I did not know about the leprosy.  Very interesting. Thanks Max

[jeannes]

I, I am new here and am not sure this is the best place to post...here or start a new thread.  Mom is getting VA A & A, plus SSR and a small pension.  We moved her into a nursing home about 3 months ago.  We are starting the process of applying for medicaid.  I can not find...and I have looked...  if Texas counts the A&A as income.  My dilemma is this...if they do count it, then I need to establish a Miller trust, as her 3 sources of income put her slightly over the $2022 monthly income limit for Texas Medicaid.  But as I understand it...if she is accepted for Mediciad, then the A&A benefit drops to $90/month...which would put her below the income limit and I wouldn't need the Miller Trust.  As she is not quite 'there' due to assets, wouldn't it be easier to just start petitioning the VA to drop her benefits to the $90?  She has enough in assets to cover the reduction in monthly income for at least 3 months.  Any thoughts?  Thanks!

[KarenO]

My understanding is that A&A is not counted as income for purposes of Medicaid eligibility but after you go on Medicaid the A&A drops to $90 as you mentioned.  My Mom lives in Florida but I am not sure if this is state specific. 

[Fit2009]

Hi Jeannes, KarenO is correct - it is by State, but most follow the federal regulation to exclude A&A for eligibility purposes - those that don't are usually just doing it incorrectly, some have more liberal rules.
This site has a few of the specfic states regulations - here is their Texas link:
 http://www.elderbenefitsconsulting.com/medicaidandthevapensi/texas.html

[AnnieN]

A further question on this if I may jump in...in our State A&A is excluded from eligibility for medicaid purposes but I'm thinking about how this actually works.  When I apply for medicaid we will have spent down to 2K.  So does the 2K exclude all of the money that we have received from A&A since my loved one has been accepted?  If this is the case, my loved one will be eligible for medicaid sooner than otherwise. For example, she may be eligible at 10K if eight thousand of that is attributable to A&A.  The A&A money is not currently kept in a separate bank account from the rest of her money, if that makes a difference.  It will be after I have been declared fiduciary but I'm waiting for that process to finish so that I have instructions as to banking.  Cheers, Annie

[vbcoder]

AnnieN ;
The way I understand it is that Medicaid in most state do not count A&A benefits as income but once it's in a bank
account it's considered an asset.As you know, the bank account can not exceed $2000 at any time to qualify for Medicaid.

If I'm wrong maybe someone will correct me.

[tkharr]

Does anyone know how the rules for Medicaid and A & A apply in North Carolina?  If someone had Medicaid first, then received the death pension benefit but later received an increase to the point that it  put the recipient's medicaid eligibility in jeopardy, then how can this be resolved?

[AngelaManz]

For Medicaid, income is considered as "income" in the month it is received, and only as an asset if it is held into the next month.  A&A is not considered as income for Medicaid purposes.  However, if the A&A income is held by the Medicaid recipient into the next month, such that his/her assets are now over $2,000, then that will cause ineligibility for Medicaid.  The easiest way to handle that is to purchase something that the Medicaid person needs to keep them under $2,000 in countable assets. 

If the person has Medicaid first and is in a nursing home, then that person will only receive the $90 per month of A&A.  This is in addition to the $40 personal needs allowance that Medicaid allows the person to keep.  The same rules apply though - the person on Medicaid cannot have more than $2,000 in assets. 

The statement that the bank account cannot exceed $2,000 at any time is not correct.  As stated above, money received during the month is income and not counted as an asset unless it is held into the next month.  So for example, if Dad has $1900 in his account and goes on Medicaid, when he receives his income of let's say $2000, it will look like he is over the asset limit.  But he is not because he will pay his patient pay, keep his personal needs allowance, and then at the end of the month he should have $1940 (assets he started with, plus personal needs allowance).  At some point, the $40 per month will cause his assets to go over $2,000 and then he will need to spend a little bit to get back under.

[vbcoder]

Best way to get the correct answer is to give the wrong answer...hehe..

Thanks AngelaManz for correcting me...I should have stated that the monthly balance should not exceed $2000...