Eligibility Question

Discussion in 'Eligibility Questions' started by mcmcdonald, Mar 6, 2015.

  1. mcmcdonald

    mcmcdonald Newbie

    Should my mother-in-law apply for Aid & Assistance if her assets exceed $80,000? I have been reading this website's wonderful advice and forum threads but I am still confused. "Mom" just moved to a "residential care facility" (in Oregon); she needs one person assistance with most ADLs (activities of daily living), has some dementia and her monthly care costs approx $4,000. She is fortunate to have long-term care insurance which pays $85/day and has some investments (mutual funds, annuities). She has not yet sold her home. Any advice appreciated!
     
  2. 330PMC

    330PMC Newbie

    you can, it doesn't hurt. the 80,000 number has to do with when the VA is required to do an administrative decision. it isn't a limit.

    that being said, if she could live off these assets for a "reasonable period of time," she'll most likely be denied. there isn't a definition of what a reasonable period is. but if her assets will last her 18+ months i wouldn't be optimistic about being approved.
     
  3. mcmcdonald

    mcmcdonald Newbie

    Now I'm wondering if we should file Form 21-4138 to get my mother-in-law a VA File number and "into the system" to ensure that she may attain retroactive assistance if/when her assets are depleted in the next year. Advice?
     
  4. Vet65

    Vet65 Newbie

    Do you know when the 3-yr look back will begin? Tks
     
  5. vetadmin

    vetadmin Administrator Staff Member

    Not sure of the time frame they would allow for implementing it or the effective date. Open comments close on Mar 24th, and then they have to review, and respond to those that make valid points about the change.

    The hope is that if everyone is calling their state Reps to inform them of the VA's action, Congress will be able to stop them since they are acting without "authority". For now, it's a wait and see what they do situation.
     
  6. mcmcdonald

    mcmcdonald Newbie

    Thank You for the replies....my MIL is, since 2/11/15, paying for her assisted living care (approx $4,000/month + deposits/fees, meds). I am asking EVERYONE I know to contact their congressperson and unfortunately, I believe my congressman/Ron Wyden is promoting the "look back", aargh! I will advise my family to take a "wait and see" approach in the event filing too early would be the wrong thing to do. :)
     
  7. vetadmin

    vetadmin Administrator Staff Member

    Senator Wyden was behind the Pension Poacher investigation, and his office only authorized "one" subpoena in spite of all the folks I gave them to interview. They only wanted to make their point, and not what the real issue was.

    Depending on what her assets are versus what she is spending, you don't want to file too soon.

    Please tell your Governor's office as well as many would end up having to file for Medicaid, which will be on the State's dole. Governors need to know this.
     
  8. VA Legal Team

    VA Legal Team Full Member

    Your mom's net worth may not be the main issue. Her medical expenses are 4k per month. You said she receives $85 per day for LTC. What is her other monthly income (SS, pesnion, etc...)? Depending on that total, her income may be too high for the benefit, regardless of her net worth. Since you didn't mention gifting, I'm unclear why vetadmin told you not to apply and what penalties she was referring too.
     
  9. vetadmin

    vetadmin Administrator Staff Member

    VA Legal,

    My comment should have been removed as it was in response to another post.

    Agree that if Mom's short-fall is enough to offset the modest LTC amount, it would be worth making application depending on what other expenses she may have.
     
  10. mcmcdonald

    mcmcdonald Newbie

    ??? Hi VetAdmin & VetLegal, I'm now more confused as to what to advise my MIL to do...to apply before 3/24 for A&A or to wait? Her monthly SSecurity is $1241 and she receives $1062/month from pensions/draws for a grand total of $1895/month income.

    her assisted living is $3872/month, her doctors' copays and meds she pays separately, she pays all maintenance/utilities for her former residence/house and her car, credit card and insurance bills plus cable/internet/TV at her assisted living apartment...she has travel/gift/misc. costs also.

    Her assisted living room/board is $3872/month.

    We only yesterday mailed the claim for the long term care at $85/day. Her portfolio of stocks/bonds is not included in any of this info - her residence is market assessed at $250,00 or less.

    File or not? We can submit a full claim and time is of the essence if we need to file befoe the 3/24 vote. Yikes! HELP PLEASE!
     
  11. vetadmin

    vetadmin Administrator Staff Member

    Not have a complete financial picture, and not being "advisers", let me just point a few things out.

    Only her expenses for the facility are going to carry weight with the VA. Based on the figures you provided, she is negative at the end of the month from income to care expenses.

    Her former residence expenses do not get factored in here, and the concern is if she can maintain those costs, she is not lacking in resources.

    You mention stocks and bonds. Those are counted as assets and depending on values, could count against her.

    If in addition to her monthly care expenses, she has a policy that pays $85.00 a day, you will have to adjust what she is actually out of pocket.
     
  12. mcmcdonald

    mcmcdonald Newbie

    Thank You! The family has decided to wait to apply for now and re-evaluate in a few months to see how her assets are holding out. We heard from my MIL's care facility that she was assessed after her initial 30 days there and has gone to a lower care level which saves her about $300/month.

    Anxious to hear how the VA proposal goes today.....I have mailed/emailed/phoned state and national reps - hope it helps! :)
     
  13. vetadmin

    vetadmin Administrator Staff Member

    Thank you for reaching out to your state representatives.

    We are hopeful that enough attention was brought to the matter, and that the VA will not be able to get away with this.
     
  14. newpenny

    newpenny Jr. Member

    You need to go on the "Daily Show" I am serious! I saw the Monday" Daily Show". Many times Jon Stewart has talked about :
    "why is it so hard for veterans to get the help they need after they fought!"

    On the Monday show of the "The Daily Show", Jon Stewart highlighted the struggles of some veterans to obtain the health care they needed. He was talking about the "Choice Program"
    The rule kept many who lived far from hospitals by roads from using the program.
    ]Jon Stewart pointed out how much money was being saved by this "as-the-crow-flies" miles.

    This is what happened on Tuesday:
    But on Tuesday, seemingly in response to what Stewart called his "damning piece of investigative joke-a-lism," the Department of Veterans Affairs changed the rule and will now use actual driven miles based on Google Maps rather than "as-the-crow-flies" miles.

    "The Daily Show" has just made a huge difference in the lives of veterans, helping many gain access to a program they were unfairly kept from using.
    The Choice Program, which was put in place to speed access to medical care after it was revealed that some patients had been waiting months for treatment, allows veterans who live far from VA facilities to get out-of-network care closer to home.
    The problem? To be eligible, you have to live 40 miles from the nearest VA facility using "as-the-crow-flies" miles.
    "Because that is the least-meaningful way to judge how hard it is to get somewhere for non-crows," Stewart said on Monday night's "Daily Show" as he highlighted the struggles of some veterans to obtain the health care they needed.
    The rule kept many who lived far from hospitals by roads from using the program. But on Tuesday, seemingly in response to what Stewart called his "damning piece of investigative joke-a-lism," the Department of Veterans Affairs changed the rule and will now use actual driven miles based on Google Maps rather than "as-the-crow-flies" miles.
    As he stated on his show, these changes were in the works long before his show aired but were made public after his show aired. Only wish they could act so quickly! Still, love his holding feet to the fire.
    The change in language will double the number of veterans eligible for the Choice Program.
    you can see it here.
    http://www.huffingtonpost.com/2015/03/25/jon-stewart-veterans_n_6937380.html
     

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