Frequently a war-time Veteran (or the widow of a war-time Veteran) who is receiving Aid & Attendance benefits also needs Medicaid. And, despite the prevalence of misinformation, a Veteran can receive both the Aid & Attendance benefit and Medicaid, so long as there are out of pocket expenditures toward care costs which are in excess of 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; and 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.
This receipt of both Medicaid and VA Aid & Attendance benefits 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 & 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 & Attendance full benefit payment, designed to help offset the cost of long term care, is no longer needed. Consequently, the payment should be scaled back from the Veteran’s full benefit rate of $1912 (for 2020) to a special $90 per month rate. This $90 per month benefit is to be used as the Veteran desires for incidentals and items of clothing, for instance.
The scale back to $90 is often the knee-jerk reaction when Medicaid is also being received by a Veteran on Aid & Attendance. As noted above, this is not a correct reaction especially 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, then there are consequences to 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. It is the Veteran’s responsibility to know when to contact the Veterans Administration to advise it that he is only eligible for $90. A Veteran simply does not want to be in the position of receiving an overpayment demand notice, creating the need for filing a notice of disagreement or requesting a waiver from the VA.
Unfortunately, the Veterans Administration has made it extremely complicated for a Veteran to follow through on his responsibility to advise the VA he is not entitled to the full Aid & Attendance benefit payment. Moreover, most Veterans need to notify the VA repeatedly because the full benefit payment continues to come in and not switched over to the $90. 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 3 new forms which are required to be completed. If you have this problem or have questions about the special $90 benefit, let us assist you in making sure you are doing all you can to protect yourself.