Our firm can assist Veterans, and surviving spouses of Veterans, to obtain valuable help when they need in-home care, need a protective environment, care in an assisted living community, or in a nursing home. The Veterans Administration (VA) has an underused benefit called the Special Monthly Pension Benefit.
There are certain criteria that must be met. The Veteran didn’t have to serve in combat, just serve on active duty (not reserve duty) during a period of war. The Veteran, or surviving spouse, must have unreimbursed medical expenses (not covered by Medical insurance) that come close to or, exceed their income. They must also have less than approximately $130,000 in assets. If there are more than $130,000, assets can be converted or transferred to a trust, but other rules apply.
A friend or family member (other than a spouse) can even be paid to provide in-home care for a Veteran or surviving spouse. If the care services are being provided by an unlicensed caregiver, there are certain conditions that must be met. For a friend or family member to be a paid caregiver there must also be a valid personal care contract in place (drawn up by an Elder Law attorney) and the caregiver must be receiving no more than fair market value for services that he or she is providing. Without a valid personal care contract, the payments may not be considered payment for in-home care and will be considered “gifts” by Medicaid resulting in penalties that could have easily been avoided.
A Simplified Example: Harry Smith is a 67-year-old Veteran and, due to his health needs, his doctor has stated he needs assistance with bathing, dressing, meal preparation, and medication administration in order to remain at home. He and his daughter, Jane, consult with the doctor and Harry and Jane agree that she will spend 5 hours a day with Harry, 7 days a week. The fair market value for her services is $12 per hour, and they enter into a personal care contract listing the terms of the agreement.
Harry’s income is $1800/month, his medications are $200/month, and he is paying his daughter $1680/month. Rather than deplete his savings of $45,000, he applies for the Special Monthly Pension Benefit through the VA. The VA considers the $200/month for medications and the $1680/month he is paying to his caregiver daughter un-reimbursed medical expenses and “subtracts” the amount from his income. In other words, when calculating his pension, the VA considers his income to be a negative $80. He applies for benefits and is eligible for $1,703/month to help cover the cost of his prescriptions and his daughters care contract!
If you or someone you know is a Veteran, or the surviving spouse of a Veteran, receiving care in their home, please encourage them to file a claim for this benefit. It would be best to seek the guidance of an experienced Elder Law Attorney who is familiar with Veteran’s benefits. An attorney skilled in Elder Law can provide a Veteran and the Veteran’s family with pre-filing consultations to determine the appropriate steps that must be taken and to be able to determine if it would be right to apply for this VA benefit.