Follow
Share

My Mom is on Medicaid in a nursing home. The $90 VA benefit might increase her bank account enough that it could cause her to exceed her $2000 Medicaid asset limit. (Her bank account is quite a bit lower than that due to life insurance value.) She gets to keep $60 of income due to state Medicaid law and uses that or a little more than that for personal care, but if she had more she could have a phone and maybe use the beauty shop more often. But I can't let the $90 VA benefit impact her Medicaid eligibility.

Find Care & Housing
Regarding being eligible for LTC NH Medicaid and VAs Aid & Attendance, my understanding is what Becki, Glad & Isitreal wrote, you can have 1 or the other but not both simultaneously.

However as Medicaids LTC program usually does NOT cover AL, being able to get VA A&A is really good as between the VA A&A $$ and whatever retirement income they get, it can make paying the 3k-4K a mo for AL more affordable & for longer period of time.

But when they go into LTC at a NH, it’s better to drop VA A&A and instead go totally onto Medicaid as Medicaid pays all room & board costs which can run 5k-12/15k a mo. So between Medicare and Medicaid everything covered in theory. If their having to do a spend-down before NH Medicaid eligible, A&A is good to add into the $ for spend down phase till they get down to the 2k impoverishment required for LTC Medicaid.
Helpful Answer (1)
Reply to igloo572
Report

PB - the confusion can come from referring to the VA $90 as AID & ATTENDANCE. $90 is NOT A&A. Strike A&A from your vocabulary

It’s instead a $90mo “Allowance”. The VA version allowance of the Medicaid $60 for TX personal care allowance. It is not income for the month received. Just like the $ 60 PNA is not Income for the month received. It is an allowance. It does NOT get included in the copay or SOC (share of cost) required to be paid to the NH.

HOWEVER, the month after both the VA $90 and the Medicaid PNA $60 are received, it becomes an asset. Remember Asset maximum is 2k. So you cannot just let the $150 a mo build up in mom’s checking account or the NH trust fund (if you as dpoa went that route and let NH become payee, you don’t have to, I didn’t for my mom but had the trust account with like $150-$200 for incidentals). BUT You have to make sure that each & every month her assets are under 2k.

Why? Well TX has an annual recertification for LTC Medicaid. I had no idea and was totally unprepared with all paperwork packed away, that was a fun weekend.... Anyways the first recertification letter and questionnaire came a year after the month before my mom was approved. And questionnaire required 4 last months of bank statements and balance of any NH trust fund account. If any of those 4 months had shown her to be over 2k, it can turn into eligibility issue for Medicaid. So you have to spend her $150 in some way. For us, it was a beauty shoppe appointment with payment deducted from the NH trust fund account. I let the rest of the $ build in her checking account as I lived out of state so would instead do a bigger spend at Target, HEB every 3 months or so instead.

Often the NH charge for cable and the amount is magically $60!!!, so the entire Medicaid PNA stays at the NH unless you opt out of cable in writing to the NH. Your lucky as your mom has an extra $90 to spend. She can use it for anything for herself, so a life insurance payment is ok, buying a pair of those ugly but beloved by grannies SAS shoes is ok; but buy buying a graduation gift for grandkids is not.
Helpful Answer (1)
Reply to igloo572
Report
ptbtexas Aug 27, 2018
Thank you igloo - very helpful!
(0)
Report
More info from http://elderbenefitsconsulting.com/medicaidandthevapensi/texas.html

- For a non-SSI Medicaid recipient in an institutional living arrangement who has a VA pension capped at $90 per month, the total PNA may be up to $150 ($90 VA plus up to $60 PNA).

- The Texas Medicaid Regulations are silent on the impact A&A benefits have on countable resources and therefore appear to be included in the total resource (asset) limitation
Helpful Answer (0)
Reply to ptbtexas
Report

Thank you all. I appreciate you taking the time to respond. I have heard it both ways (the VA A&A $90 benefit (a)can or (b)cannot be combined with the $60 Medicaid allowance) from people that were supposed to know. Prior to this I spent hours searching but could not find the answer to my question. Trying a different web search phrase just now I think I finally found the answer: "If a Medicaid recipient were to save the A&A benefit and thus allow their resources to exceed $2,000 in any one month after all bills are paid, they would lose their Medicaid benefit. If they gave the money away that gift would be a recognized as a transfer and subject to the same consequences. Therefore, the Medicaid recipient must spend their A&A award for their own benefit in the month in which they receive it." This is from http://www.war-vets.org/can-i-receive-va-aid-attendance-and-medicaid-at-the-same-time/ I will try again to get through to some knowledgable person at the Medicaid office to get a confirmation. If she can have both then I'll have to see if the extra costs of her life insurance payment (paid by family so far) plus phone service (not yet installed) might be close to balancing the $90 A&A benefit.
Helpful Answer (0)
Reply to ptbtexas
Report

It is considered income and if you were able to get it with Medicaid, which I doubt, it would have to go to the NH and that would effect her Medicaid.

I am pretty sure that this would be a double dip and could cause some problems. If you are the POA and are the one applying can't you ask the VA and your Medicaid contact? This would ensure you know their rules for your area.
Helpful Answer (0)
Reply to Isthisrealyreal
Report

No you cannot receive both Medicaid and VA Aid and Attendance. You can be approved for both, but once Medicaid finds out during one of their audits, you will be required to drop one or the other. There may also be a penalty involved.
Helpful Answer (2)
Reply to anonymous439773
Report

I would check with the VA and Medicaid. My understanding is that you cannot receive both.
Helpful Answer (1)
Reply to gladimhere
Report