One More Question - Aid and Attendance vs. Housebound

Discussion in 'Share Your Personal Experience' started by tanya0090, Apr 4, 2016.

  1. tanya0090

    tanya0090 Newbie

    I know there have been several posts about this but I didn't get a good understanding from the responses or perhaps my question is a little different.

    I assisted my father with applying for this benefit, he is 86 and has been diagnosed with lung cancer. His hospice social worker had the appropriate form completed by his doctor which basically stated that he is unable to prepare his own meals and needs help with walking bathing etc. Well, when I called the VA to inquire about his claim the first thing they said was they see he had a claim for "housebound". I didn't argue with that because at that point we just really need them to process his claim as quickly as possible and I didn't want to say anything to interrupt the process. But my question is, I've learned through this website that housebound is the lesser of the three pension tiers but we were really hoping he would be approved for the maximum for aid and attendance. Any knowledge regarding this would be greatly appreciated. Thanks!
     
  2. Kaylin

    Kaylin Hero Member Staff Member

    tanya0090,

    I am so sorry of your father's diagnosis. My father went through a cancer battle himself (esophageal cancer) so I can understand how this is a very difficult time for you and your family.

    For those who wish to remain in either their own home or the home of a family member they can apply for the Housebound level of the Improved Pension. The VA will automatically consider this level if your father does not fully qualify for Aid and Attendance.

    The criteria for Housebound requires that the claimant needs regular assistance, but is not as limited as those who would qualify for Aid and Attendance. Care can be provided by family members or outside Caregiver's agencies. Families need to be reimbursed for the care and services they are providing just as you would an outside agency.

    To be eligible for Housebound Benefit:
    A veteran alone must have countable income LESS than $15,233 a year
    A veteran with a spouse must have countable income LESS than: $19,093 a year

    These are excluding one house and one vehicle, just as the A&A benefit. I hope that helps answer some of your questions.
     
  3. tanya0090

    tanya0090 Newbie

    Thank you! This helps a lot!
     
  4. Kaylin

    Kaylin Hero Member Staff Member

    You're welcome. :)
     
  5. toxdoc49

    toxdoc49 Jr. Member

    This is helpful. Thus, if the Aid and Attendance benefit is not awarded, the VA will automatically look at the housebound level of benefit.

    My question is, what does the level of income for a surviving spouse of a vegteran have to be less than to qualify for the housebound benefit? And this of course is determined by the 'countable' income figure.
     
  6. Kaylin

    Kaylin Hero Member Staff Member

    To be eligible for Housebound Benefit:
    • A veteran alone must have countable income LESS than $15,233 a year*
    • A veteran with a spouse must have countable income LESS than: $19,093 a year*
     
  7. toxdoc49

    toxdoc49 Jr. Member

    Thank you. What category does a surviving spouse of a veteran fall into?
     
  8. Kaylin

    Kaylin Hero Member Staff Member

    toxdoc49,

    Closer to the veteran category I listed there. You're welcome!
     
  9. toxdoc49

    toxdoc49 Jr. Member

    So here is an issue I was thinking of: Normally the application would be submitted to the VA in support of the A&A benefit. In order to have this considered, the person has to be in an assisted care facility or other type of care where there is financial need for them to cover the expenses in a facility. So presumably, the person is already in a facility when this application is submitted.
    Now, if the person wants to remain in the home or be cared for by the family member, I am guessing that the expense part of the VA application is going to look different. Meaning, the person caring for them will be listed in section X of 21-534. You say that they automatically consider the housebound benefit, and that's fine too. But are they looking for something specific when they consider the housebound benefit compared to the A&A level? If, in theory, the veteran and/or spouse is spending all of their income in one way or another for home care, does there have to be a clear demonstration of expenses exceeding income for home care? I'm not seeing a discussion of this specifically in relation to the application. Also, is there a defined level award amount for the housebound benefit compared to the A&A regardless of what is demonstrated on the application? Here again, it might just be that the amount of money needed to care for someone in the home would be equal to the A&A level in certain cases.

    Not to overload, but I am thinking that one should really apply for the housebound benefit if there is no way to cover the additional cost of assisted living in a facility, since (a) the VA takes quite a bit of time to approve it, and (b) one could always submit the additional documentation if/when the person moves to a facility for a higher level of care. That way, one does not have to risk taking out loans to cover the cost.
     
  10. Kaylin

    Kaylin Hero Member Staff Member

    Good questions here, toxdoc49.

    As for the amount that is awarded per month for housebound vs. aid and attendance:
    Housebound Veteran: $1310 (maximum)
    Housebound Surviving Spouse: $864 (max)
    Aid and Attendance Veteran: $1788 (max)
    Aid and Attendance Surviving Spouse: $1149 (max)

    So the numbers are very different for each benefit. I wish I had a better answer for you on why the VA determines housebound vs. the A&A benefit in some circumstances. Technically, a person may be using an in-home care service or in-home health aide and showing these expenses are depleting their income/assets and still be able to qualify for the Aid and Attendance benefit. Since it is more likely that an assisted living facility or a nursing home would be more expensive than an in-home care service, that is why a veteran/surviving spouse is more likely to be awarded A&A if they are in one of these facilities outside of their own home.

    I hope this clears up some of your questions? I am also going to see if Debbie Burak has any further explanation on this matter that is not coming to my mind at this moment.
     
  11. vetadmin

    vetadmin Administrator Staff Member

    One can remain in the home and have services come in, and be awarded the higher level of Aid and Attendance. It depends on the Physician's Evaluation as to the level of issues that now require assistance with daily living.

    Someone who only needs a lower amount of assistance and is paying less for those services could be rated at Housebound, while someone who needs 24/7 care and wishes to remain in their home would be rated higher for both care and award amount.

    I believe you are confusing the two as either way, you do not make application until such time that services are being provided either in-home or facility care. You have to be able to show the expense for care regardless. You cannot make application based on future or anticipated expenses.

    If lower services are being provided and the situation changes where a higher level of care becomes necessary or the applicant moves into facility care where their expenses increase along with services, if you were awarded less than the max award of A&A, then you simply would notify the VA of the changes to receive an adjustment in the award amount.

    The process for processing an application for the Housebound level versus Aid and Attendance is the same and one does not get processed any faster than the other.
     
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  12. toxdoc49

    toxdoc49 Jr. Member

    Thank you Kaylin, I appreciate that; it does clear things up. It is nice to know the benefit levels, I was not able to find that out. I suppose one needs to list basically all of the veteran's or spouse's income as being spent on their care by the caregiver, or is it even necessary for the VA to award a housebound benefit level?
     
    Kaylin likes this.
  13. toxdoc49

    toxdoc49 Jr. Member

    Thank you. I'm guessing you still have to show expenses outstripping income, even for the housebound benefit. And a family member can be a caregiver, correct?
     
  14. Kaylin

    Kaylin Hero Member Staff Member

    My best advice would be to clearly indicate the care expenses for the veteran and/or spouse and also clearly indicate the income and assets. As vetadmin mentioned, the benefit type (housebound or A&A) will be awarded based on the level of care needed and the current expenses vs. income for each applicant. Yes, a family member can act as a caregiver for these benefits.
     
    toxdoc49 likes this.
  15. TOMBAY

    TOMBAY Newbie

    Haven't found easy way to simply ask question so,hope this gets to right person. My brother has been on A and A for nearly seven years now and will.hopefully be transitioning to Medicaid since he is running out of money. He receives $1788 monthly now from the VA. Medicaid folks have asked for letter from VA stipulating amount of his A and A.
    The VA letter shows total benefit as $1788; net amount paid $1072; and A and A as $716. I assumed entire $1788 was A And A. Can someone explain what the $1072 is. Many thanks. Tom Bay
     
  16. toxdoc49

    toxdoc49 Jr. Member

    My understanding is that a family caregiver can look at the average rate for caregiving in their area and then have a record of how many hours per week are spent caregiving to give the figure for the caregiving expense
     
    Kaylin likes this.
  17. Kaylin

    Kaylin Hero Member Staff Member

    Yes, that would be a good way to go about it.
     
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  18. Kaylin

    Kaylin Hero Member Staff Member

    Tombay,

    It is my understanding that the $1072 is the MAPR (Maximum Annual Pension Rate) that your father was awarded and the $716 is the actual death pension added on to that number. It is a bit confusing, but that is how the VA does it. The $1072 is not really important for applying for Medicaid, as long as it shows the full $1788 on the form somewhere.
     
  19. TOMBAY

    TOMBAY Newbie

    Thanks, Kaylin
     
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