Have A&A, aplying for Medicaid, now what ?

Discussion in 'General Discussion' started by Thankful_12, May 13, 2016.

  1. Thankful_12

    Thankful_12 Newbie

    My parent has the full $1149 A&A benefit awarded while in Assisted Living . Moved from Assisted Living to Nursing Home in November. Currently, at final stages of Medicaid application. The Dept of Social/Senior Services took into account the $1149 when doing their calculations knowing that parent is in a nursing home. They did note that they would like “proof that the VA has been advised of Nursing Home placement and apply (application) to adjust payment.” The ’adjust payment’ part made no sense since parent is at the max and I assumed they thought maybe she was entitled to more now. When I searched on this forum I saw something about sending a Nursing Home Statement of Occupancy and filling out a Statement in Support Of Claim :

    http://www.veteranaid.org/forums/in...ility-nursing-home-what-form.3357/#post-13716 “If she is already receiving the maximum amount allotted to a veteran ($1,788) or veteran's spouse ($1,149) then it will simply be an update on her living status.”

    BUT This morning after searching on the word "Medicaid" on the forum I found: “I can tell you, that when an applicant who is receiving A&A goes on Medicaid, the lose all but $90.00 of the benefit. The $90.00 has to be spent on personal items. It cannot be spent on any medical expenses as the state is paying for their care.”

    Well now I am confused. Why would the folks who are processing the Medicaid app use the $1149 in their calcs for parent's monthly contribution, while under Medicaid, if they know it is going to go down to $90 upon notifying the VA that my parent moved. And of course, the Medicaid coverage goes back starting in a past month; does the VA want the 1149 minus 90 'back' for those months if this is true ?
     
  2. Kaylin

    Kaylin Hero Member Staff Member

    Thankful_12,

    The fact that if an applicant goes on Medicaid while receiving the A&A benefit, the VA will drop that benefit down to $90 is correct. The VA will not allow someone to be on Medicaid AND receive the A&A benefit in it's entirety.

    As for how/why the Dept. of Social/Senior Services took into account the $1149, I am not sure. Medicaid varies from state to state so it is difficult to know the answer to that question. I would speak directly with them, as we are not Medicaid experts here.

    Once you notify the VA of their receiving of Medicaid and indicate the date the money was started, that should be the date that the VA will take into account any moneys owed back to them from the A&A benefit. They would let you know how much was owed back depending on when the applicant was awarded Medicaid, either way.
     
  3. toxdoc49

    toxdoc49 Jr. Member

    I'm guessing that Medicaid takes over for the cost of the nursing home which is why VA wants their money back. I'm also guessing that one does not want to apply for Medicaid if they have or are applying for the A&A Va benefit. I think there are two different paths here, one by way of the VA for help with assisted living/nursing care, and one through Medicaid. But I am still learning about the process.
     
  4. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    Exactly! When one is presented with the choice of Medicaid or the A&A benefit, it is best to evaluate the situation specific to the applicant and see which one will be more fruitful for them in helping to pay for care. Thank you for explaining that as well. :)
     
  5. toxdoc49

    toxdoc49 Jr. Member

    I am happy that I could contribute in some small way! I am currently faced with this situation myself. I've got the A&A app filled out, but have thought about Medicaid because there are services available there as well. That said, however, assisted living facilities/nursing homes have less available openings under Medicaid because they don't get paid the full amount through Medicaid.
     
    Last edited: May 23, 2016
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  6. Ptrician

    Ptrician Newbie

    I have a similar problem. I put both my parents into a nursing home in November 2015 in Massachusetts. The were both receiving Aid and Attendance before entering for several years.
    1. their gross pension award is $2120. Broken down as Beneficiary's Primary portion $969.00, Spouse's Portion $435.00, Special monthly pension (Aid and Attendance) $716.00
    2. Mass Health (Medicaid) approved them as of November 2015.
    3. Mass Health is requiring that we pay them $1404.00 per month the combined benefit of the Beneficiary and Spouses portion towards their nursing home care.. Which we are. They are not asking for the Aid and Attendance portion. I am setting the $716.00 aside as I am sure the VA will come looking for that.
    4. I notified VA via phone of the change in status of Nursing Home November 16. Received my WE RECEIVED YOUR APPLICATION LETTER dated Dec 1.
    5. Sent Mass health proof of approval in writing in Feb. Once again got the standard letter dated March 4.
    6. Have also called them April 7 only to be told they have all they need .
    My question is we are still being paid by the VA each month. When does the $90.00 per month begin. This is as difficult to ask them to stop paying as it was to get the benefit in the first place.

    Thank you
     
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  7. Kaylin

    Kaylin Hero Member Staff Member

    Ptrician,

    That is certainly an interesting situation you and your family are in with the Medicaid and Aid and Attendance issue. Very strange that the VA has not reduced your parents' benefit amount to $90.00 per month yet! It is smart of you to set aside the $716.00 per month, as I'm sure the VA will come looking for that money returned since your parents have been on Medicaid.

    I would use a Statement in Support of Claim form 21-4138 to send into the VA, alerting them that your parents have been approved and have been on Medicaid since the date they were awarded the Medicaid (whatever date that may be). I would also include a copy of a record or letter to show that the Medicaid was given to them. You may inquire in the letter about reducing your parents' amount of the A&A benefit to $90.00 a month. That would be my next step to try.
     
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  8. Ptrician

    Ptrician Newbie

    Thank you Kaylin, I have sent all that to them in Feb. I did not attach that form so I guess I will resubmit today with that. I just think it is sad because I know there is someone out there who needs the benefits from the VA. And now that my parents received help for MASS Health I would like to see someone else get what they deserve.
     
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  9. Kaylin

    Kaylin Hero Member Staff Member

    Ptrician,

    I'm sure you'll get this worked out soon with the VA. It is very noble of you to say that, to want your parents' money they are currently receiving in addition to the Medicaid to go back to a veteran or surviving spouse who needs it even more.
     
  10. Kaylin

    Kaylin Hero Member Staff Member

    Ptrician,

    Can you please let me know if your parents' A&A benefit amount was dropped to $90 a month for the month of June? Since they should have gotten that payment today or pretty soon. If not, we might be able to refer you to a lady who is more of an expert on Mass Health and could help you sort this out.
     
  11. toxdoc49

    toxdoc49 Jr. Member

    I find this helpful. I have (or will have) a similar situation for my mother in law. My question is, does the VA in any way increase the A&A benefit if needs increase, so that there is not again a financial shortfall? Or, (as I anticipate this to be the case with my mother in law where needs will increase), would Medicaid be a better option? I know the forum doesn't deal with Medicaid, but I am asking if I am right about the VA benefit, so I can decide which path to take. We have no other way of paying for assisted care except with the VA benefit or through Medicaid. Just looking at the long-term view. Thank you.
     
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  12. Kaylin

    Kaylin Hero Member Staff Member

    Yes, the VA can increase the A&A benefit amount if the applicant (in this case, your mother-in-law) is not already at the highest awarded amount and they are showing more financial need than they did before. You will definitely have to look into how Medicaid compares to A&A for your mother-in-law, as it varies by state. You're welcome!
     
  13. Ptrician

    Ptrician Newbie

    Sorry I did not reply sooner I was on vacation and did not see this. No they have not reduced it. We were paid again August 1st. I just got off the phone and they said they closed the file. I was like but you are still paying full benefit. Now this Yari at the pension center said she is sending me some form my father has to sign to request to stop benefits. Well we don't want to stop he still would like the $90.00 if that is what he is entitled to. Yes if you could refer me to someone that would be great. Thank you.
     
  14. Kaylin

    Kaylin Hero Member Staff Member

    I sent you a private message.
     
  15. Ptrician

    Ptrician Newbie

    I just want to say thank you to Patty Servaes from Elder Resources Benefit Consulting for her help with this issue. I contacted her and she responded on the set appointment date ( and half hour before the scheduled time). In my particular case my parents keep the Award as long as the are both alive. The nursing home receives the pension and the aid and attendance portion is kept separate for their needs. Once their is only one parent does it revert to the $90.00 benefit. But remember this varies from State to State. So if you have a question I highly recommend her company. Her contact information is on this website. Oh and the consult was FREE.
     
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  16. Jet

    Jet Newbie

    My father (single with no dependents) receives the A&A $1788 benefit and was admitted to a nursing home in May. I was informed yesterday that he has been approved for Medicaid. I am going to notify the VA about this (I'm expecting the A&A will be reduced to $90). Until the VA reduces the benefit, the reoccurring $1788 (if not reduced) could potentially put him at risk of losing Medicaid, which he really needs. Any tips on which forms I should send in so that we can get this amount reduced somewhat quickly?

    I was going to send in the 21-0779. Should I send in anything else?
     
  17. Ptrician

    Ptrician Newbie

    I would send the approval letter from Medicaid showing he is receiving the benefits and what date it begin. Check to make sure you are sending to the correct address as that has changed recently. This site has that information. And I would make sure you send so you get a confirmation receipt. Good luck
     
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  18. Kaylin

    Kaylin Hero Member Staff Member

    Thank you for your help with that, Ptrician! I would follow Ptrician's advice, Jet. Yes, always mail return receipt.
     

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