veterans and medicaid

Veterans and Medicaid

Sometimes we deal with a war-time Veteran (or widow of a war-time Veteran) who is receiving Aid and Attendance benefits but also needs Medicaid.  A Veteran can receive both an Aid and Attendance benefit and Medicaid so long as there are out of pocket expenses toward care costs which exceed the Veteran’s income.  This is especially true when a Veteran is receiving care in his own home and pays for private caregivers in addition to those provided by Florida Medicaid.  It is also true when a Veteran is in an assisted living facility and has a share of cost which exceeds his monthly income even after Medicaid pays its contracted rate to the facility. 

The ability to receive both Medicaid and Aid and Attendance remains true even if a Veteran is in a skilled care facility, although the circumstances become far more rare for a Veteran to have Aid and Attendance and Medicaid while in a nursing home. 

When covered by Florida Medicaid in a nursing home, most of the time there are no out of pocket care expenses.  This means that the Veteran’s Aid and Attendance full benefit payment, designed to help offset the cost of long term care, is no longer needed.  Therefore, the payment should be scaled back from the Veteran’s full benefit rate of $1912 (2020 number) to a special $90 per month.  This $90 per month is to be used as the Veterans needs for incidentals such as haircuts, toiletries and clothing.

The scale back to the $90 benefit is often the knee-jerk reaction when Medicaid is also being received by a Veteran on Aid and Attendance. 

As noted above, this is not a correct automatic response when the Veteran is at home or in an assisted living facility.  Yet, when the full benefit should be scaled back and it does not get scaled back, there can be consequences for the Veteran for failing to do so.  The Veteran is guilty of receiving a benefit which is not warranted; and the Veteran can be responsible for an overpayment demand from the Veterans Administration when they eventually discover their error.  It is the Veteran’s responsibility to know when to contact the Veterans Administration to advise that he is only eligible for $90.  A Veteran is well advised to hold any added sums (exceeding the $90 per month) in a separate account for ease of repayment to the VA when they make their repayment demand.  Otherwise, if the Veteran spends the funds he may need to request a waiver from the VA.

Unfortunately the VA can be slow in stopping payments.  Also they have made it extremely complicated for a Veteran to follow through on his responsibility to advise the VA he is no longer entitled to the full Aid and Attendance benefit payment.  Moreover, most Veterans need to notify the VA repeatedly because the full benefit payment continues to come in and does not get reduced to the $90 amount.  This is even more distressing when the Medicaid office continues to count the VA benefit as part of the required co-pay to the nursing home.

The VA recently changed how a Veteran must notify it that he should no longer receive a full benefit payment.  There are three new forms which are required to be completed.  If you have this problem or have questions about the special $90 benefit, let our firm assist you in making sure you are doing all you can to protect yourself or your loved one.

Give us a call if you need help with benefits for Veterans. Burzynski Elder Law at 239 434-8557.

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