Aid and assistance of various kinds are available for veterans through the V.A. or Veterans Administration. This assistance can be in an assisted living facility, at home, in a nursing home or provided by others, including friends, family members, or healthcare professionals. Veterans in Sacramento may be eligible for nursing home assistance, without knowing it. If you or a loved one falls into this category, here is what you need to know.
Eligibility for V.A. long-term care benefits
Some veterans or families of veterans are unaware of all of the long-term benefits available through the V.A. These “extended care” services provided by the V.A. include nursing home care, as well as, non-institutional long-term care. If you or a loved one falls into one of the following categories, you may be eligible for these extended care services:
- Veterans with a service-connected disability rating (or combined disability ratings) of 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 nonservice-connected disability and who meet income and asset criteria.
There may be other ways to demonstrate eligibility, which is determined on a case-by-case basis. Priority is typically 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.”
The long-term care benefits available from the V.A.
Long-term nursing care is available through nursing homes and other types of facilities. The V.A. has its own nursing homes, as well as private nursing homes that contract with the V.A. to provide care for veterans. These other facilities are referred to as “community nursing homes” within the V.A. These facilities are often used by veterans who live in an area where there is no V.A. facility located nearby. The V.A. also operates Community Living Centers, which provide short-term residential care in conjunction with ongoing outpatient care.
The typical cost of V.A. long-term care benefits
The co-pay for extended care services through the V.A. is based on the income and/or assets of the veteran and the veteran’s spouse. If the services needed are expected to last more than 180 days, then assets will also be considered. The maximum co-pay for extended care services is $97 per day. The exact amount depends on the veteran’s V.A. health system priority group, the veteran’s financial circumstances, and the type of care or service provided.
Applying for V.A. long-term care benefits
When you apply for long-term care benefits with the V.A., it requires a separate application from enrollment in basic V.A. Medical Care coverage. When you apply for extended care, the following types of information are necessary:
- Spouse’s name, date of birth, and Social Security number
- The current income of both the veteran and the veteran’s spouse
- The value of fixed and liquid assets of both veteran and spouse (only if applying for nursing home or other residential care)
- Information identifying all health insurance, including all parts of Medicare (a copy of an insurance card and the veteran’s Medicare card)
For qualification purposes, it may be necessary to prove functional physical and/or mental impairment, serious enough to require nursing home-level care.
Assistance with elder law issues
An Elder Law attorney is one specially trained and experienced in legal issues that affect seniors. Because of their specialty, they are better equipped to understand the needs of their clients and to anticipate problems many seniors may face, such as nursing home care. Elder law involves not only legal advocacy but also education, counseling, and future planning. Elder law attorneys work closely with seniors and their families in order to effectively address each client’s specific needs and goals.
If you have questions regarding nursing home care, or any other estate planning needs, please contact the Northern California Center for Estate Planning and Elder Law, either online or by calling us at (916) 437-3500.