Nursing Home Care: A VA Benefit Many Veterans are Unaware Of

Posted in Uncategorized on January 15, 2015
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Written By: Claire Simmons

The members of the Armed Forces depend on the benefits provided by the Veterans Administration. There's one important benefit, however, which is often overlooked. This is the Aid and Attendance and Housebound Improved Pension benefit.

Also known as the A&A, this benefit can be used to help pay for:

  • Nursing home residency
  • Assisted living costs
  • Home caregivers (including sons and daughters, but not spouses)

The A&A is a pension benefit. These benefits are available to all veterans who served at least 90 days with at least one day during wartime. Veterans do not need to have service-related injuries in order to qualify.

According to the VA, the A&A is one of the agency’s lesser known benefits. In 2011, about 1.7 million World War II veterans were alive. But only about 38,000 of those veterans were granted A&A benefits that year.

This situation hasn’t improved much. The benefit isn't particularly difficult to quality for when all is said and done. The problem is the V.A. employees haven't always been educated about the existence of this benefit.

The Veteran’s Administration is the second-largest federal agency in the U.S. With so many employees, there are going to be some knowledge gaps. This means the person applying for the benefit, and their family will need to be informed and proactive when seeking these benefits.

History of the Aid and Attendance and Housebound Improved Pension Benefit

The A&A was first implemented in 1951. This is considered the third tier of VA’s Improved Pension. The other two tiers are “Basic” and “Housebound.” Each tier has a different level of benefits and qualification. In the event a veteran or their spouse doesn’t qualify for A&A, they’re encouraged to look into the Basic and Household tiers.

The A&A Pension isn’t just for veterans who are ill. If the veteran is still independent but his or her spouse is ill, this benefit also applies. The spouse’s medical expenses must completely deplete the combined income of the married couple.

Applying for Nursing Care Benefits

Once a veteran reaches the age of 65, he or she is automatically classified as “totally disabled.” The requirements on the VA page do not clearly explain that all veterans earn this classification at the age of 65, so applicants incorrectly think they need an actual disability classification from the government.

There are also some income qualifications the veteran must meet. First, the veteran must have less than $80,000 in assets. Additionally, their income must be below the Maximum Annual Pension Rate. For 2017, the MARP is:

  • $21,528 for a single veteran
  • $25,524 for a veteran with one dependent
  • $13,836 for a single, surviving spouse of a deceased veteran
  • $16,920 for a veteran with a sick spouse

Determining Income

Income doesn’t include SSI, welfare benefits, or unreimbursed medical expenses. This can include Medicare and Medigap; long-term care costs including nursing home, assisted living facility and in-home care fees; some over-the-counter and prescription medications; and other care costs. These various expenses must occur monthly and aren’t paid for by insurance.

How Benefits are Calculated

After determining expenses and income, the VA then calculates how much you'll receive each month. The VA pays the difference between the veteran's income and the MAPR. Here’s an example:

Gerald, 66, is a single veteran from the Army. He lives off of a dual income of $18,000 from Social Security and $10,500 from a pension. His total income is $28,500 annually.

Gerald lives at home, but he needs in-home assistance. This costs him $20,000 each year. Additionally, he pays $1,400 for Medicare and $600 for supplement insurance. This brings his total annual medical expenses to $22,000.

The VA subtracts his medical expenses from his income. This makes his countable income $6,500. He’s entitled to $15,500 in Aid and Attendance Benefits.

The VA doesn’t reveal maximum allowable assets. Experts estimate the maximum is $80,000. Income limits also vary. The maximum is estimated to be between $20,000 and $23,000. Note this estimate is after subtracting all medical expenses, caregivers, assisted living fees and/or nursing home fees.

A Word of Caution

This unknown nature of this program had led to a unique opportunity for scams. The federal government forbids anyone to charge someone to help fill out any VA forms. Unfortunately, the forms can be very complicated. Plus, not many people are aware of the restrictions on charging for help. So many veterans end up paying for thousands of dollars for fraudulent consultations.

Another source of problems can sometimes be financial planners within the assisted living facilities. They’ll pretend to conduct seminars on the A&A benefit. In reality, they’re searching for elderly residents who have too much money to qualify. They’ll then try to convince those residents to move funds into annuity products. This earns the financial planner a nice commission but doesn’t help the veteran secure benefits in any way.

The bottom line is this: Filing out the A&A forms is free. Nobody should charge a veteran any type of form consultant fee. Unfortunately, the forms can be a bit complicated to navigate at times. Elderly veterans are encouraged to have family or friends help them with the application process.



The Aid and Attendance and Housebound Improved Pension is perhaps the most important benefit yet also the one most misunderstood by the public. Available for any veteran age 65 or older with 90 days of previous military service, including at least one day of wartime service, the A&A provides a variety of options for long-term care. Nursing home care, assisted living care and in-home care are all covered.

Many senior veterans have benefitted tremendously from this program. If any veteran or member of their family is looking for nursing home care assistance, the Aid and Attendance and Housebound Improved Pension is often an effective solution.

Last Updated: June 29, 2017

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