Long-Term Care Benefits for Veterans

August 24, 2016 Health, Insurance, Personal Finance
Long Term Care Benefits for Veterans

By Eric Jorgensen

Learn more about Eric at NerdWallet’s Ask an Advisor.

Veterans have access to health and long-term care benefits that can have a significant impact on their family’s finances. The Department of Veterans Affairs will pay for certain long-term care services for disabled and low-income veterans. With help covering long-term care costs, many veterans and their families can focus on other important aspects of their financial planning.

There are many options for veterans to take advantage of as they age and require care, but often veterans don’t even know they may be eligible. Here’s a look at the various benefits available:

VA health care system

Those who served in the active military — except for those dishonorably discharged — or who were in the Reserves or the National Guard and served their full period of duty are eligible to enroll in the VA’s health care system. Enrollment is free, although treatments may require a copay, depending on the veteran’s financial position. Additionally, veterans who enroll establish eligibility for future long-term care services even if they use a different primary health insurance provider in the meantime.

Although the armed forces do a good job helping those with traumatic injuries access their benefits, many veterans still leave the service without taking advantage of the health system. If you’re a veteran or have a family member who is, make sure to find out about all benefit options available to you.

Veteran-Directed Home and Community Based Services

Enrollment in the VA health care system also grants access to the Veteran-Directed Home and Community Based Services program, which provides veterans with a flexible budget to purchase long-term care services. These could include a geriatric evaluation to determine needs and create a care plan, adult day health care, respite care, skilled home health care and more. There is no age limit; all enrolled veterans are eligible if a physician determines there is a need and the service is available in their location.

Unlike many traditional long-term care insurance policies, this program does not cover room and board in residential care settings such as assisted living or an adult family home, a licensed home that provides care for a small number of residents. Veterans will need to rely on Medicaid, which covers long-term care for low-income individuals, family resources or their own savings, investments or insurance to fund these options.

Veterans Pension

The Veterans Pension benefit is a tax-free, monthly payment for low-income veterans. Your family income must be below the limit set by Congress — $12,868 annually in 2016 for veterans with no dependents. If you’re eligible, your payment amount is the difference between your income and the yearly limit. However, you may be able to deduct from your income certain medical expenses and some forms of income, like Supplemental Security Income.

To be eligible, veterans must have served at least 90 days of active duty — or at least 24 months if they entered active duty after Sept. 7, 1980 — with one day during a wartime period. The veteran must also meet at least one of the following criteria:

  • Age 65 or older.
  • Totally and permanently disabled.
  • A patient in a nursing home receiving skilled nursing care.
  • Receiving Social Security Disability Insurance or SSI.

The veterans pension is not the same as a military pension, for those who served long enough, or VA disability compensation, for veterans who have a service-connected disability that meets certain requirements.

Veterans can’t receive both VA disability compensation and the veterans pension; they will receive the higher of the two benefits. And if you’re getting a military pension, you’ll likely exceed the modified income limits and not be eligible for a veterans pension. Receiving a veterans pension may also make you ineligible for Medicaid.

Aid & Attendance and Housebound allowance program

Veterans who are eligible for the veterans pension may also qualify for an aid and attendance allowance in addition to the pension, increasing their monthly benefit amount. In 2016, the adjusted-income limit is $21,446, and it follows the same dollar-for-dollar reduction as the veterans pension.

In addition to meeting the requirements for a veterans pension, a veteran will need to meet at least one of the following requirements:

  • Needs assistance with one of the six activities of daily living: personal hygiene, dressing, eating, using the toilet, mobility and grooming.
  • Is bedridden.
  • Is blind.
  • Is a patient with mental incapacity in a nursing home.

Another benefit, the housebound allowance, is payable to veterans who are confined to their home because of a significant, permanent disability. This will also increase the base veterans pension payment, but by a lesser amount. In 2016, the benefit for a single veteran without dependents is $15,725 annually.

Veterans can apply for one or the other of these two programs, not both.

Community Living Centers

VA Community Living Centers, formerly called nursing homes, provide 24-hour skilled nursing care, restorative care, access to social workers and geriatric evaluation and management. Some may also provide recovery care for mental health, special care for mental incapacity like dementia, and respite and hospice care. The services offered vary, so veterans should contact the facility near them — there are 132 nationwide — to find out what’s available.

To be eligible to use a VA Community Living Center, you must be enrolled in the VA health care system and be medically and psychiatrically stable. Eligibility and the cost of care are based on your service status, clinical need, disability and finances. If your health declines after you move into a VA Community Living Center, you may be eligible for continuing care if the facility is equipped for it.

Armed Forces Retirement Homes

Another option for veterans is independent of the VA. There are two Armed Forces Retirement Homes, one in Gulfport, Mississippi, and one in Washington, D.C., that offer a full scope of care from independent living to long-term care. However, you must be capable of independent living to move in. You do not need to be enrolled in the VA health care system for eligibility as these are run by a separate federal agency.

Commissioned officers are not eligible unless they served at least 50% of their military service as an enlisted member, warrant officer or limited duty officer. Veterans are generally eligible if they meet one or more of these criteria:

  • Have served at least 20 years and are 60 or older.
  • Are unable to earn a livelihood due to a service-connected disability.
  • Served in a combat zone or received hostile-fire pay and are unable to earn a livelihood due to injuries, disease or disability.
  • Are female veterans who served prior to 1948 with “compelling personal circumstances.”

These homes are not free. Fees are computed annually based on a percentage of the veteran’s total income. The percentage increases with the level of care but is capped so it won’t exceed a certain amount per month. If veterans meet the criteria, these could be a great option prior to needing long-term care services. The home will provide care as residents develop a need and, with capped fees, they may remain more affordable than other facilities.

Many options

These benefits are meant to ensure that veterans get the care they need regardless of their financial status. Helping veterans apply for the benefits they are entitled to lessens the financial stress on the whole family. Families caring for aging veterans may be able to cut expenses and redirect that money into savings for themselves, for things like retirement, college funding or other goals. Beyond that, they have the added security of knowing their parents or grandparents are being cared for.

Families may find additional help, for free, through approved veterans service organizations such as the Veterans of Foreign WarsDisabled American Veterans or the American Legion. A complete directory of veterans service organizations is available on the VA’s website.

Eric Jorgensen is a fee-only financial planner with MainStreet Financial Planning in Odenton, Maryland, and Washington, D.C.

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