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Modern Estate Planning Blog

Elder Law & Special Needs Planning

QUESTION: Does the VA cover nursing home care?

February 28, 2013

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

Nursing Home Care is a regular, covered benefit for these two groups:

  • Veterans rated 70 percent service-connected or greater
  • 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 nonservice-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.

Even if you are not a member of one of these groups, you may be found eligible for Nursing Home Care in Sacramento if space and resources are available.

To see if you may be eligible for VA health care enrollment, please visit http://www.va.gov/healthbenefits/apply/.

If you are not eligible based upon the above criteria the VA may still be able to assist with nursing home costs through its Improved Pension benefit (often called “Aid & Attendance”).  Improved Pension is a benefit for wartime veterans who meet income and asset requirements. You do not need to have a service-connected disability to qualify for Improved Pension, but must meet the following requirements:

1. Be a veteran who served at least 90 days of active duty or the surviving spouse of a wartime veteran (married at the time of veteran’s death).

2. At least one day of active duty had to be during wartime:

  • WWII – 12/7/41 to 7/25/47
  • Korea – 6/27/50 to 1/31/55
  • Vietnam – 8/5/64 to 5/7/75
  • Gulf War – 8/2/1990 through a date to be set by law or Presidential Proclamation

3. Does not need to have been in combat.

4. Discharged other than dishonorably:

  • Honorable discharge
  • Discharge under honorable conditions
  • General Discharge
  • Bad conduct discharge, Discharge under other than honorable conditions, or Undesirable discharge may still be eligible after a “character of service determination” hearing

5. Income** less than $1,731 per month for an unmarried veteran, or $2,053 if married, after out-of-pocket medical expenses are considered (less than $1,112 per month for a surviving spouse). (determined on a case-by-case basis)

6. Net worth less than approximately $50,000 (determined on a case-by-case basis)

** Income for VA purposes = gross income minus unreimbursed medical

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