Little-known benefit can help vets, and spouses, with assisted living

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By Saul Friedman

Newsday (MCT)

Here is some old but good news for veterans of modest means who were in service during wartime and need medical and nursing care.

On Dec. 19, 2006, then-Veterans Affairs Secretary Jim Nicholson issued a press release "to inform wartime veterans and surviving spouses of deceased wartime veterans about an underused, special monthly pension benefit called ‘Aid and Attendance.’"

The press release stated, "Although this is not a new program, not everyone is aware of his or her potential eligibility. The Aid and Attendance pension benefit may be available to wartime veterans and surviving spouses who have in-home care or who live in nursing homes or assisted-living facilities."

Eligible veterans need not have served overseas or in combat; they must have served during the period of a war: World War II, Dec. 7, 1941-Dec. 31, 1946; Korea, June 27, 1950-Jan. 31, 1955; Vietnam, Aug. 5, 1964-May 7, 1975; Persian Gulf War, Aug. 2, 1990 to a date not yet determined.

The press release got little notice, perhaps because Veterans Affairs wanted to save money. But it has surfaced among veterans and elder lawyers such as Frank L. Buquicchio of Islandia, who is accredited by the VA to give advice to and represent veterans.

The head of his law firm, Vincent Russo, said that, other than the press release, the VA had chosen not to publicize this benefit. But, he added, "It can be a lifesaver for veterans and their spouses because the additional monthly payment from the VA can make assisted living more affordable."

As word of the benefit got around, elder law firms throughout the country became active in pursuing the benefit for clients.

Buquicchio noted that, under federal law "no one, not even attorneys, can charge veterans for the pension application."

Aid and Attendance, he told me, is meant "for the veteran or surviving spouse who have unreimbursed medical expenses. (The cost of health insurance is considered a nonreimbursed medical expense.) It is most ideally suited for someone who needs assistance at home and is paying for an aide or is in assisted living. Assisted-living charges are considered by the VA as a medical expense." Assisted living is not supported by Medicaid.

Buquicchio added that the eligible income and asset levels are similar to Medicaid, but not as restrictive.

The person’s home is exempt, and the VA will do an "age analysis" to determine if the veteran (or surviving spouse) has sufficient assets to pay for his or her own care. The basic requirement is that the veteran requires ongoing aid and attendance for the performance of activities of daily living.

This requirement is waived if the veteran is in a nursing home. The 2008 maximum benefit for a married person is $1,842 a month and $1,555 for a single person. The benefits are tax-free. And needy surviving spouses may get more generous benefits.

You may learn more by calling Veterans Affairs at 800-827-1000, or by visiting its Web site at Click on "What are Aid and Attendance and Homebound benefits? How do I apply." You also may get help from a veterans’ service organization.

Now for some not-so-good news. As I’ve mentioned previously, most Medicare beneficiaries will find no increase in their monthly Part B premiums (now $96.40) because the law provides that Social Security benefits, which likely will be frozen for two years, cannot be reduced for current beneficiaries.

But under the Medicare Modernization Act of 2003, new Social Security and Medicare enrollees and current beneficiaries with household incomes higher than $85,000 this year will pay much more. Under the law, Part B premiums must account for 20 percent of all Part B costs in the Medicare budget; the rest comes from general revenues.

With Part B premiums frozen for 75 percent of Medicare beneficiaries, revenue from these Part B premiums won’t reach 20 percent. The gap must be made up by new and more affluent enrollees. They will pay on a sliding scale, between $134.90 and $308.30 a month, depending on their income. Visit, click "Medicare Premiums and Coinsurance rates for 2009" then click "Medicare Part B monthly premiums in 2009" at the bottom for details.

Medicare advocacy groups have called for an end to means testing because the high premiums encourage more affluent couples to leave Medicare for private insurance. In addition, many older couples are penalized with higher premiums for one-time increases in income.


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