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Social Svs told me to spend down the insurance and it would be up to the VA Pension breakdown whether he will be eligible to reapply for Medicaid. His VA pension is broken down as follows: $207= Gross Benefit Amount, $326 = Spouse (which we did not realize there was any designated for mom), $705 Aid and Attendance. I need to know if this will qualify him after I spend down the insurance, or what I can do to allow him to stay in the nursing home? He cannot live alone anymore. He cannot take care of himself and we work and cannot stay with him 24/7.

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Confu - so I'm assuming the insurance was a whole life policy and there is a cash value that you are going to have to spend down & then dad is a vet.

If you think realistically that mom will be able to continue to live on her own for a while and that mom will NOT need a NH in the near future, i would approach this very differently. If this could be the case, then mom is considered the "community spouse" for Medicaid. That doesn't mean community as in divorce/community property either, it means "living in the community". As such she is NOT expected to impoverish herself in order to dad to be able to get on Medicaid. In general the community spouse can have about 113K in assets of their own - they do not have to themselves become impoverished to the 2K in assets that the NH spouse does to qualify for Medicaid. this is pretty important distinction to be aware of. Also the community spouse can - if need be - apply for MMNA. Monthly maintenance needs allowance - which is kinda like alimony for the NH set. If mom has needed dad's income in order for her to continue to live in the community, then she can file for MMNA. Sometimes the MMNA will be all of his SS and retirement, so that he will not even have any Medicaid co-pay.MMNA tends to be set rather low but you can appeal the amount. If there is a mortgage or the spouse has children as she is a much younger 2nd or 3rd wife, those are easily reasons why to get MMNA.

About the VA A&A, they can continue to get it but at a reduced rate when they go into the NH. It then becomes $ 90.00 a month but the good part about it is that it is fully his money - it does not count for this co-pay (or his "SOC" share of cost). It gives you all an additional $ 90 a month for dad to have to spend @ the NH. At my mom's NH there are lots of military, so they have the $ 60 a month personal needs allowance under Medicaid and also the $ 90 VA A&A. So each mo they have $ 150 to spend on themselves that is not a part of the Medicaid co-pay. For men, that could mean they can go to the barber shop @ the NH or pay for someone to shave them, or replace their shoes or clothes more often. It adds up!
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When Mom applied for Medicaid, they considered her assets her SS monthly payment and her pension. Aid and Attendance did not count in as an asset because once she's on Medicaid, Aid and Attendance will be stopped. VA told us that while it may take a while for them to actually stop the payments from going into her account, they will expect us to send the money back to them for all of the months Medicaid was picking up her bills. The way they explained it was that Aid and Attendance was to help defray the cost out of pocket to the assisted living facility. But since Medicaid was picking up all of her SNF costs and Medicaid is part federal money, there's no need for the Aid and Attendance.
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you need an elder benefits consultant asap. we worked with ERBC, but there are many places that can help, including working directly with the VA. Most nursing homes have a financial person to help you. Make some calls or go to the Money and Legal tab above.
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