What happens when a veteran or surviving spouse receiving Aid and Attendance goes into a nursing home?  A reduction in benefits may occur but only after the veteran or surviving spouse becomes eligible for Medicaid while in the nursing home.  When this happens, an unmarried veteran or surviving spouse’s Aid and Attendance pension benefit will be reduced to $90.  See 38 CFR §3.551(i).

However, if the veteran is married or has a dependent child living at home the reduction is not automatic.  If the spouse or dependent child has unreimbursed medical expenses then the veteran may continue to receive all or a part of the Aid and Attendance payment, even after entering a nursing home and qualifying for Medicaid.  Why is this the case?  The VA counts household income and deducts recurring household out-of-pocket medical expenses when determining eligibility for Aid and Attendance pension.  Even though the veteran is in a nursing home, the spouse’s income and out-of-pocket recurring medical expenses are counted when determining eligibility.

The lesson to be learned here:  Do not allow the VA to automatically reduce a married veteran’s Aid and Attendance award to $90 if the spouse at home has recurring out-of-pocket medical expenses.   Instead, submit evidence of the spouse’s recurring medical expenses once the veteran is approved for Medicaid, and the VA will recalculate the veteran’s eligibility for Aid and Attendance and could approve an amount over $90 per month.

ElderCounsel hosts educational events to train attorneys on Veterans Benefits.  To find the next class or to order the recording and materials from a prior class, please visit our Education Calendar and  Marketplace on our website.

Valerie L. Peterson

Valerie is the Executive Director of ElderCounsel, LLC , an organization that provides document drafting software, education and support to elder law and special needs attorneys across the United States.  Valerie is a frequent lecturer on elder law and Veterans Benefits.