VA’s $90 Nursing Home Rule

By | Right to the Point, Veterans | No Comments

Eligibility for Medicaid causes difficulty for those beneficiaries who also want to receive Pension income in a nursing home. For a single person, VA refuses to pay the full Pension benefit if that person is eligible for Medicaid and will only pay $90 a month towards nursing home costs. For a beneficiary with a spouse at home, the combination of Pension and Medicaid may not work due to Medicaid rules.

Consider these important points:

  1. VA pension, based on UME’s and A&A, pays a monthly rate based on accountable income, minus UME’s, with additional monies for dependents.
  2. The “$90 Nursing Home Rule” states: if a veteran, without a spouse or children, (or a widow without dependents) is approved for Arizona Medicaid (ALTCS) and is a resident of a Skilled Nursing Facility (with a Share of Cost assigned or not), NO MATTER what their private pay rate of pension was, they WILL be reduced to $90 per month of VA pension.  VA and ALTCS regulations identify this $90 as “totally A&A” and can’t be assessed for Share of Cost, or countable toward monthly income. Usually, the $90 is additional personal funds for the client.Though rare, ALTCS clients who are either Service-Connected (SC), or widows who receive Death & Indemnity Compensation (DIC, meaning the Veteran died SC) are not affected by the $90 Nursing Home Rule because they are NOT pension programs.Also, even though ALL of the criteria for reduction to $90 are met, veterans and widows who reside in a STATE HOME (usually 1 or 2 per state) are totally EXEMPT from the $90 reduction.  Our State Home is run by AZDVS, and is on the same grounds as the VAMC at 7th St. and Indian School Road. They are exempt from the reduction, and also subject to ALTCS assessment for Share of Cost and monthly income limit.
  3. A great part of this regulation is that a VA overpayment can’t ever be created; all overpayments are waived.  For example, if a widow at $1113/month pension is approved for ALTCS effective 3/1/13, and the VA finally adjusts it 8/1/13, the $7,200 overpayment is waived.

For more questions on ALTCS eligibility and the VA Pension program, contact JacksonWhite today.

Call us at (480) 464-1111 or fill out the form below.

Does The Department of Veterans Affairs cover nursing home care in AZ?

By | ALTCS, Veterans | No Comments

The Department of Veterans Affairs (VA) may provide long-term care for service-related disabilities or for certain eligible veterans.  Nursing home care can be provided in VA or private nursing homes for veterans who are in need of care, but are not acutely ill and not in need of hospital care.  Priority is given to veterans with service-connected disabilities.  Veterans who do not have service-connected disabilities for which they’re entitled to compensation must agree to make a co-payment.

To be eligible for nursing home care, you must be enrolled in the VA health care system or be eligible for VA health care without the need to enroll.

Those eligible for VA nursing home or non-institutional long-term care include:

  • Veterans with a service-connected disability rating (or combined disability ratings) or 70 percent or higher.
  • Veterans with a 60-percent service-connected disability rating who are unemployable, or who have a rating of “permanent and totally disabled.”
  • Veterans with a service-connected disability that’s clinically determined to require nursing home care.
  • Veterans who require nursing home care for any non-service-connected disability and who meet income and asset criteria.
  • Other veterans on a case-by-case basis, with priority given to veterans with service-connected disabilities and those who need care for post-acute rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury.

In addition, Veterans who do not qualify for extended care may receive Aid and Attendance from the VA, which is a different program with different criteria. This program is designed to help veterans stay in their homes instead of going to a nursing home. Unfortunately, the amount a Veteran can receive in Aid and Attendance is insufficient to pay for skilled care. At that point it is frequently necessary for the Veteran to transition to Medicaid for payment of Nursing Home Care.

If you have any questions about elder care, feel free to call an elder care attorney at JacksonWhite. You can call 480-818-6912 to schedule a consultation with an elder care advisor.

Some Vets May Get VA Pension

By | Arizona Republic Column Articles, Veterans | No Comments

Aging and the Law is authored by the attorneys at JacksonWhite Attorneys at Law and addresses legal issues that arise for the elderly and their families.  The article below was featured in the Arizona Republic on September 22, 2012. Questions can be sent to, or by using the contact form below.

Q: My husband is a veteran of the Vietnam War, and I hear that certain benefits may be available to supplement our income.  Is this true?

If your husband is a veteran of the Vietnam War who was discharged under other than dishonorable conditions, then, yes, he may be eligible for certain benefits.  In fact, even if your husband passes away, you could be eligible for certain benefits as the widow of a veteran.  The VA actually offers a host of benefits to eligible veterans, but the benefit designed to supplement veterans’ income is referred to as the VA Pension.

The VA Pension is available to certain veterans who meet a resource and an income requirement.  As to resources, the VA Pension is only available to those whose net worth is “not excessive.”  While there is no hard and fast rule here, it is generally safe to say that those with a net worth of about $60,000 or less meet the resource requirement.  As to income, the VA Pension can supplement a married veteran’s income up to about $1,300 per month and a single veteran’s income up to about $1,000 per month.  This figure can increase dramatically if the veteran requires the regular aid and attendance of a caregiver.

The VA Pension is a dollar-for-dollar offset program, so for every dollar that a veteran’s net income falls short of the maximum Pension award, the VA provides one dollar of benefit.  The catch here is that net income is calculated by deducting veteran’s unreimbursed medical expenses from his or her monthly income, which means that even veterans with a relatively high income can still qualify for the benefit if they have costly medical expenses, such as those typically associated with long-term care.  Generally speaking, veterans can engage in certain types of planning to prepare themselves for eligibility.