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gorilla Asked April 2014

My uncle is in a nursing home under Medicaid. He just got awarded a monthly VA disability check. Must this be reported to NY Medicaid?

My 57 year old uncle is in a LTC nursing home (about 1 1/2 years now). Medicaid is paying for his medical care and the nursing home takes his monthly social security disability check to help cover the costs of him living at the nursing home. He's just been granted a Veteran's monthly compensation disability check. Must this new income be reported to Medicaid? Will Medicaid disqualify him now and throw him out of the nursing home?

EXPERT K. Gabriel Heiser Apr 2014
If a VA Pension recipient, with no spouse or child, is a patient in a nursing home and has qualified for Medicaid coverage, then the Pension amount cannot exceed $90 per month, after the end of the third full calendar month following the month of admission to a VA-run (VHA) nursing home or starting with eligibility for Medicaid in a private nursing home (after the month of admission). Veterans residing in state-run veterans’ homes are exempt from this $90-per-month limit. Such $90/month payment is not considered income and does not have to be paid to the nursing home, and it is paid in addition to the personal needs allowance.

moondance Apr 2014
They already know. It goes through the system that way.

I really do not know if VA disability will touch the Medicare grant...
wish I could be of more help....you'll find out regardless....

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newhope Apr 2014
I do have POA, but I have been told by the personnel office that the fed govt does not recognize POA's. They instead sent me a long form which basically says I will be responsible for his bills. Only then would they send me his notice of annuity. I did not fill that out - with my husband in a nursing home I cannot take on more liability. Even though I explained it to them, they don't seem to get it that my brother needs that paper to apply for Medicaid. (Or don't want to get it!). My brother even signed a letter to that effect, to which he has not received a reply. Medicaid will not accept the net amount he receives, for which I have documentation - they need the gross amount. Between my husband's and my brother's care, I have never been through so much red tape in my life. I understand privacy laws, but sometimes they are carried to the ridiculous when all a person is trying to do is help out a loved one. This is one of the reasons caregivers are under so much stress.

BarbBrooklyn Apr 2014
I would talk to the VA about the possibility of a VA nursing home setting; I would talk to the NH administrator about how this sort of thing gets handled. Or you might want to talk to an disability rights lawyer about this.

pamstegma Apr 2014
Gorilla, his entire SS and VA has to go to the Nursing Home, Medicaid will only make up what those two do not pay. If you keep the check, you will be sued for lots and lots of money. And you will lose.

BarbBrooklyn Apr 2014
newhope; Not really an answer to your question, but if nothing else, you should get POA from him; just being "next of kin" is not enough in a lot of situations that your brother may be facing in the future. If nothing else, if you were POA, they would have sent that letter to you.

igloo572 Apr 2014
Gorilla - so young @ 57! You really need to speak with the NH to see what works best to provide total coverage.

I'm not sure if VA disability is the same as Aid & Attendance. But if it is this is what I've heard. My mom is in a NH that has lots of military (my Dad was a fed who worked within the military too) & it seems that A&A solo does not work well for paying the costs of a nursing home. A&A is rarely enough to cover the difference between NH cost & their income (SS, SSDI). On the other hand, Medicaid will cover this difference in cost so in most cases Medicaid is a better to be on to pay for everything for those in a NH.

Eligibility for Medicaid seems to cause difficulty for those who also want to receive their pension income in a nursing home. For a single person, VA usually refuses to pay the benefit if that person is eligible for Medicaid and will only pay $90 a month towards NH costs. BUT for a beneficiary with a spouse at home, the combination of A&A and Medicaid is can work but seems to be tricky to deal with. If your uncle has a spouse who on her own has significant recurring medical expenses or has a child that is a minor, it seems they can keep VA and the uncle can totally be on Medicaid. There is a younger 2nd wife @ my mom's NH who gets his VA as their son has asthma so they meet the requirement of recurring medical expenses and her personal income & assets are low enough so that it doesn't affect his Medicaid income & assets.

Really its just so specific to the individual circumstances so carefully ask @ the NH what is best to have him there with no costs to family. Good luck.

newhope Apr 2014
My brother, an 88-year bachelor, is in a nursing home. As his next-of-kin, I am looking after his affairs. He has some funds to carry him through a few months, but then will have to go on Medicaid. I have all the papers he needs to apply except for the federal pension that he gets as a former government employee. He receives a notice of annuity every year; however, I could not find it among his papers. I requested a copy from the U.S. personnel dept. They would not send it to me and instead sent it to the address they have on record for him. My niece has been checking his mail, but it was never received. My brother then signed a letter on the nursing home stationery with the same request, indicating his change of address. He has not yet heard back after some time. I am now considering consulting an elder lawyer. My question is: Is this something an elder lawyer handles? Would an elder lawyer be able to get this information to satisfy Medicaid's requirement? I am at my wit's end as time and money are running out.

nevergiveup1966 Apr 2014
You must report it and he will not get tossed out of the house

newhope Apr 2014
I agree with pamstegman because I have looked into that with the VA and the nursing home where my brother is. I understand that Medicaid allows the recipient $35/month for personal use, such as clothing, etc., but takes all other income to pay the nursing home. Because of this, I probably will not even fill out the form sent to me by the VA - another long, complex form. I believe the pension would apply if the person is in a VA nursing home. I would have placed my brother there if the nearest one weren't so far from family for visits. I have been told the vets get a lot of respect in VA homes. The lady I spoke to on the phone was very pleasant and helpful.

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