Veteran Benefits for Assisted Living: What You Need to Know

If you served as a member of the United States Armed Services, you may be entitled to certain benefits that could make getting older a little easier.

The U.S. Department of Veterans Affairs offers some funding programs that can help offset the costs of specific kinds of care later in life. For some people, this benefit can be a real help when weighing how to pay for assisted living or other long-term care options.

VA Benefits vs. Medicare and Medicaid

Senior living options can get expensive, so every little bit that can help balance these sometimes hefty costs may be a relief for families.

“Veterans and their spouses have multiple financial benefits that can help cover the cost of assisted living,” says Rick Wigginton, chief sales officer with Brookdale Senior Living, a Tennessee-based senior living company with 675 senior living communities in 41 states across the country.

These benefits are separate from Medicare or Medicaid benefits, adds Dana Taylor, a social worker and senior regional manager for Veterans Home Care based in St. Louis, Missouri. Medicare is a federal health insurance program for adults 65 and over. Medicaid is a combined state and federal program that provides health coverage to low-income individuals, regardless of age.

“One of the biggest differences is in repayment,” Taylor explains.

If a veteran uses VA-provided care, neither that veteran nor the family of the veteran is financially responsible when the veteran dies.

“That is not the case with Medicaid," Taylor says. "Additionally, there typically is not a set amount of time that these benefits can be used. They are at the veteran’s disposal as needed. With Medicare, the payments for long-term care vary based on the length of stay.”

The VA, however, will not pay for a veteran’s rent in an assisted living community, Wigginton says. VA benefits “may pay for some of the extra services they need, such as nursing assistance, help with bathing and toileting and possibly even meals,” he notes.

Medicare provides similar coverage; it will not cover the cost of assisted living communities, but it might cover some qualified medical expenses incurred by residents.

Aid & Attendance and Housebound Benefits

There are a range of benefits that may kick in depending on your specific service history and eligibility. Wigginton says that "the most commonly used benefits are the Aid & Attendance Pension and the Survivor’s Pension, which is for spouses of a deceased veteran with wartime service.”

The VA’s Aid & Attendance and Housebound program is part of pension benefits for veterans and surviving spouses. These benefits, the VA reports, “are paid in addition to monthly pension, and they are not paid without eligibility to pension,” meaning that you can’t access this benefit if you're not a pensioned veteran or a survivor of a pensioned veteran.

This benefit, Taylor adds, can be used for either in-home care or care at a senior facility.

To qualify for the program, you must:

• Be a veteran of war-era with an honorable discharge or be the surviving spouse of a veteran of war-era with an honorable discharge.
• Need medical assistance.
• Need financial assistance.

Aid & Attendance kicks in when you meet one of several potential conditions, including:

• Requiring the aid of another person to perform the activities of daily living. These personal functions include bathing, dressing, eating, toileting or assistance staying safe from hazards in your daily environment.
• Being disabled to the point of being bedridden, beyond what would be considered normal recovery from a course of treatment like surgery.
• Being a patient in a nursing home because of physical or mental incapacity.
• Having very poor eyesight (5/200 corrected visual acuity or less in both eyes) or a field of vision limited to 5 degrees or less.

Individuals may qualify for Housebound benefits, which are added to your standard monthly pension, when you are “substantially confined to your immediate premises because of permanent disability,” the VA reports. Eligibility for the program is determined on a case-by-case basis and involves a thorough review by the VA.

In 2023, the Aid & Attendance Pension provides a single veteran with up to $2,229 per month, and a married veteran with a dependent child could get up to $2,642 each month.

“The VA may also reimburse contracted long-term care skilled nursing facilities for their stay,” Taylor says. The VA integrated health care system has more than 1,200 care locations and may pay for care at providers outside the VA system. For reimbursement, each facility may determine its own qualifications for that option, so you’ll need to ask at the facility where you’re seeking treatment.

“Additionally, some VA medical facilities have units that act as long-term care facilities. These are only for veterans who utilize the VA health care system,” Taylor says. In addition, there are VA skilled care facilities located in every state that are open for all veterans, but they typically carry a waiting list, she notes.

Learning About These Benefits

Despite the availability of veterans benefits, “unfortunately, many qualified veterans are underserved each year because they do not know what benefits are available,” Wigginton says.

Taylor agrees that these benefits seem to be a fairly well-kept secret. While these benefits are not widely publicized, “the fact is, medically speaking, there is a variety of assistance available as long as you’re enrolled in the VA health care system. Becoming established with the VA health care system is the key to unlocking a myriad of benefits for a veteran,” with options for everything from medical equipment to in-home physical therapy, she says.

Getting the word out about these benefits to retired or discharged service members is important because these benefits can be significant, adds Roxanne Sorensen, an aging life care specialist and owner of Elder Care Solutions of WNY, a case management consultancy in upstate New York.

Sorensen says this federal money helps her clients “stretch what their investments or savings can do.” VA benefits can perhaps “buy them a year or two instead of having to utilize all their checking, savings and annuities," she reports.

Because of this, she says she always tries to "tap into the VA system if possible, as that’s a really great way of putting someone into assisted living or assisting with nursing home placement.”

Given that it’s impossible to know how long you’ll live or how much money you’ll need, it’s important to maximize the money you’ve saved so that you can afford high-quality care for as long as possible. If VA benefits can help you do that, so much the better.

Accessing VA Benefits

To get these benefits that you’ve earned, you'll need to be proactive. “The veteran must not be afraid to ask as the services are generally not just offered,” Taylor explains.

You can start by talking with your primary care doctor and checking with your local VA. It’s also smart to reach out to your state’s veterans service officers, who are “typically state employees trained in all things VA,” Taylor explains. “Their jobs are to inform veterans of their benefits and help them access those benefits.” These officers can help you with sorting out your benefits completely free of charge.

In addition, Taylor notes that there are "a number of private agencies nationwide that help as well. Just do your homework, and be sure you’re accessing a reputable resource."

Many communities also partner with organizations that have specialized expertise in assessing eligibility and procuring benefits for veterans, Wigginton adds.

You can apply for benefits on your own as well. And while there's no shortage of advisers and consultants who can help, make sure you work with a VA-accredited individual or organization. You can check the VA’s database to find out if someone you’re considering working with is accredited.

Applying for VA Benefits

To get started in applying for basic veteran's health benefits, you’ll need several documents, including:

• Your most recent tax return.
• Account numbers for your current health insurance provider.
• Social Security numbers for yourself and your spouse.
• An application for health benefits from the VA called the 10-10EZ form.

Checking whether you have access to Aid & Attendance and Housebound benefits involve a separate application. Each state has its own Pension Management Center that processes Aid & Attendance and Housebound benefits applications.

To apply for Aid & Attendance, you’ll also need to gather several documents to help fill out an application form and then send the completed paperwork off to your state's PMC to see whether you qualify.

Documents you should have on hand in order to fill out the application forms include:

• Your discharge or separation papers (DD Form 214). These documents can be requested from the National Archives if you don’t have a copy available.
• A copy of your marriage certificate if you're married.
• A copy of a death certificate if you’re the surviving spouse who’s applying for benefits.
• A current social security award letter. This is the letter issued annually that states what your monthly social security benefits will be the following year.
• Financial information, including bank statements and statements about any stocks, bonds or annuities you may own.
• A doctor’s letter that lists your current diagnosis, prognosis and details about your ability to care for yourself.
• If you already reside in a nursing home, you’ll need a letter from the facility stating that you’re a resident.
• Other medical documents, including a list of medications, recent medical bills and insurance statements detailing your recent medical expenditures.
• A list of all doctors and health care institutions you’ve visited within the last year. (Filling out a VA Medical Expense Report can help make this list easier to draft.)
• If you're a legal guardian applying on behalf of your ward, have documentation of that relationship available.
• If you’re under the age of 65, have your employment history on hand.

With those documents gathered, you can begin filling out the application forms made available by the VA. The key documents are VA Form 21-527EZ for veterans and 21P-534EZ for surviving spouses and unmarried dependent children of verterans.

Calculating Care Costs

Ultimately, getting the best care you can afford should be the top priority. While the price of senior living will be determined by your care needs as well as the amenities you want and where you want to live, veterans benefits can help those who qualify.

“After comparing all the costs associated with living in a house to everything that comes with a senior living community, many people realize that senior living is more affordable than they first thought,” Wigginton says.

Indeed, Genworth Financial's 2021 survey (the most recent data available) found that the median monthly cost for an assisted living community is $4,500 – totaling $54,000 annually. In comparison, long-term care by a home health aide tops $5,148 monthly or about $61,776 annually. And skilled nursing in a private room will set you back $9,034 per month, adding up to more than $108,408 per year.

These are median figures, so there’s plenty of variability. It’s also worth noting that an assisted living community isn’t always the less expensive option compared to other care situations. But it warrants investigation rather than being dismissed outright as too expensive.

Dealing with finances, especially with respect to end-of-life care, isn’t easy. But it’s important to make an unemotional assessment of your financial resources and wherewithal, Wigginton says.

“To get a better understanding of your financial situation, make a list of everything you’re currently paying for. Are you providing yourself three meals a day, paying for utilities, a mortgage, home repairs, yard maintenance, transportation, cable and internet, in-home care or services?" he asks. "Then compare that to everything that’s included in independent or assisted living, where you don’t have to do much of the work and neither does your family.”

Your and a caregiver’s time and energy are worth money, so calculate that in. You may be surprised to discover that assisted living makes a lot of financial sense.

In addition to accessing veteran’s benefits, you may have other resources available to pay for a senior living arrangement. Wigginton says many people use their savings, annuities, pensions, social security and funds from the sale of a home. Long-term care insurance is another option. Any and all of these make up your unique financial picture.

In addition, it’s often helpful to speak with a financial advisor, attorney or other trusted and knowledgeable professional to help you take stock and wade through your options.

As with most discussions surrounding senior care, starting earlier is far preferable to jumping into a panicked decision late in the game.

“The challenges of aging are often compounded by waiting too long to consider your options,” Wigginton says. “Start talking about senior living options way before you have to make a decision. When you do so, you’ll have more opportunities to visit places and more time to really decide what services and amenities you want and need."

SOURCE: US NEWS