There are three tiers to this Special Improved Pension, each with its own maximum countable income level and benefits for single and married veterans. Countable Income is the amount of income a veteran or surviving spouse receives each year, AFTER deducting all unreimbursed, recurring health care expenses. This includes assisted living costs, home health care, insurance premiums, Medicare premiums, on-going prescriptions and more. Net worth is also taken into consideration valued on the date of application, and there is currently no look-back as in Medicaid.
Level one is Basic Pension available for those with the lowest income. Level two is Housebound Benefits and is for those with a physician certifying the applicant is in need of some daily help. Level three allows the highest countable income, provides the highest benefit and is called Aid & Attendance (A&A). The Improved Pension for A&A "may be granted when the veteran or the surviving spouse requires the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an assisting living facility also qualifies."