Medicaid V. A&A

Discussion in 'General Discussion' started by dfwtrader, Dec 27, 2011.

  1. dfwtrader

    dfwtrader Newbie

    I have been scanning the subjects, but not finding my specific situation. If anyone could offer up some advice it would be greatly appreciated.

    My mother is the survivor of a veteran, with assets well below the requirements, and needs day to day assistance (legally blind), but before I go through the substantial process, is it worth it?

    She is on medicaid, receives ~950/mth in SS and ~500 in "survivors benefits.

    From some of the other topics it seems that medicaid negates pretty much all the ~1000/month she would receive. Is this an accurate statement?

    Thanks in advance,
  2. vetadmin

    vetadmin Administrator Staff Member


    Given that she is on Medicaid, the state is basically paying for her care, and if you were to file for A&A, the most she could receive would be $90, and that money cannot be spent on medical expenses. It would need to go for personal items.

    Each state has different laws regarding Medicaid, so the range of award would be between $30 - $90.
  3. dfwtrader

    dfwtrader Newbie

    Thanks for such a prompt response!!

    I am terribly sorry, I mispoke. Mom is currently rapping me on the back of my head ;D

    She is on Medicare and not on Medicaid. But the other aspects of her profile are correct.

    How does A&A interact with Medicare?

    My apologies,
  4. vetadmin

    vetadmin Administrator Staff Member

    Good thing Mom rapped you on the head as there is a BIG difference!

    You need to look at the Tips and Resource tab on these forums and look at the "countable" income formula to determine where she stands. If she is in a facility, or has services coming into the home, the expenses are allowable. Keep in mind she has to be paying for care or services at the time of application in order to count those expenses.
  5. dfwtrader

    dfwtrader Newbie

    I know I know...just a brain freeze from reading all this information.

    Thanks very much! I went to the countable income tab and determined the following, playing it extremely conservative until I determine the actual numbers.

    She is 79
    ~80K in assets
    ~17,500 annual income from ss and survivors benefits
    ~currently 1250 of expenses for medicare prem
    ~16,250 allowable income

    At this point she does not currently have assisted living costs, but that will go to ~2200 per month

    Now with these numbers and since medicare does not appear to be a detriment. Would it be in your opinion that I file now or wait until she is incurring the assisted living costs?

    Thanks again for this site and all your help.
  6. vetadmin

    vetadmin Administrator Staff Member


    You are welcome, and yes, you need to wait until she is incurring the expense of assisted living. This pension is to ensure that the applicant has resources to pay for "care". Since she currently is not paying that, she would not be able to demonstate a "need" of the pension.
  7. dfwtrader

    dfwtrader Newbie

    Thanks so much for your responses. This is a great help. I have passed your site along to several groups of VVA, VFW, and Korean War Vets Assn. I am almost positive that very few of these patriots are aware of this benefit and definitely would have a tough time completing the process.
  8. vetadmin

    vetadmin Administrator Staff Member


    Thank you so much for sharing the site!! Even after all my work for the past 6 years, this pension still remains so little known. Not sure what it will take for me to get it to a national level, but I am working on it!
  9. dfwtrader

    dfwtrader Newbie


    I would be happy to help wherever possible to expand the knowledge of this benefit and your site. My mom has been blind and basically homebound without assistance in which my parents were paying for home help even when he was alive, and they never knew about this benefit. I was fortunate enough to run across the article in AOL news as we are getting ready for my mom to get residence at an assisted living facility.

    With that said, I am following your advice and getting my mother into the ALF and then applying. This transition could take a few months, so should I file form 21-4138 "Intent to file" so as to get the statutory date recoreded?

    Secondly, I realize that the benefit is based on income and assets, but is it based on actually paying for assistance or the fact that paying for the assistance reduces your income to a degree making you eligible. For example purposes only lets say someone had no assets and no income and was being assisted but for free via a volunteer. Could that person still qualify or do they actually have to be paying that person to assist them?

    Thanks again for all the assistance and as I get to know more about this, if you like I would be happy to stay on board and assist with questions or direct to resources. I can give you my contact information as I progress and have free time to offer.

    Have a great day,
  10. vetadmin

    vetadmin Administrator Staff Member


    If you file an informal claim to start the clock, the VA would look at when she started incurring expenses, so I suggest waiting until you are close and ready to move her. File the informal like 30 days out once you have selected a facility and have a move in date.

    All the VA cares about is the "countable" income, which is what is left after paying for care and services. The best case scenario is to be at zero or negative at the end of the month. Yes, it is dependent upon paying for care that otherwise would not be available without the assist of this pension. Anyone doing care and not being compensated would not count.

    Regarding your offer to help expand knowledge, please contact your local media outlets and ask for their considerations to do a segment/story on this topic. If you work for a company that needs an end-of-the year charitable donation for tax purposes, please suggest us. If you know of companies or individuals who support Veteran's issues, please suggest us. Anything helps, and nothing is too small.

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