My mother with dementia was recently granted Aid and Attendance benefits. Can this money be counted by Medicaid as income?

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My mother has to have care 24 hours/day. Medicaid cannot cover all the hours needed. As the spouse of a war time veteran, my mother has been granted $1000/month to cover additional hours needed for aid and attendance. This money cannot be used for other purposes. My mother's "real" income is $423/month from SS and $238/month as a veteran's spouse. Can the aid and attendance money from the VA be counted by Medicaid as income? Cancelled checks paid to attendants will provide proof as to where the money allowed by the VA for aid and attendance was spent

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Only a portion of the Aid and Attendance benefit will be counted as income by Medicaid.

Technically, there are three levels of non-service connected pension available: Basic, Housebound, and Aid and Attendance with Aid and Attendance offering the highest potential benefit.

Because all benefits above Basic are granted based on “unreimbursed medical expenses” incurred by the claimant it is presumed by Medicaid that benefits received above Basic are going to cost of care and are, therefore, NOT countable as income for Medicaid eligibility purposes.

Thus the only portion of the Aid and Attendance benefit received that is countable as income by Medicaid is the “Basic” amount. For 2013 the Basic benefit for a surviving spouse is $695.

If this income puts the Medicaid beneficiary over the Medicaid “income cap” for eligibility (which it looks like it will not in this case) an “Irrevocable Qualified Income Trust” can be established to maintain eligibility
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In addition because of her Aid & Attendance benefit she now is no longer eligible for the Medicare Savings Plan which used to pay her Medicare premium. So now her monthly Social Security will be $105 less.
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That used to be the case but if you check again with both the VA and Medicaid they now count the entire amount as income. You used to be able to get a letter from the VA that would note the amount of the benefit that was deemed "pension" but they no longer do that. My father is in a skilled nursing facility and receives that largest benefit available via Aid and Attendance, he must claim the entire amount as income.
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It is my understanding that Aid and Attendance amount received from VA is not countable income if it is paid in full to outsider caregiver(not family dependent) living in the same household. if this is the case you may outline this point to the social worker in the Medicaid office and you may get cooperation
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This is so interesting. I always believed my Moms A&A for housebound needing 24/7 care VA Check was reimbursement for her needs and not income.
If I tried to apply for medicare with a VA reimbursement check, I was told she wouldnt qualify so I never tried. Should I? And if she were able to receive medicaid would they take her VA check and only give her $35 a month? I would love to know the answers , thank you. Btw, I take care of her in my home, severe dementia and wont use a nursing home ever.
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Thank you very much Mr Robbins, I appreciate this info !
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My mother is in an Assisted Living Community. I just applied for Medicaid for my mother & they did in fact count the full Aid & Attendance amount as income. However, The Aid & Attendance benefit will stop once Medicaid kicks in. She cannot be eligible for both since the government considers that "double dipping".
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