VA Benefits and Medicaid Eligibility
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- Francis Marshall
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1 Presenting a live 90-minute webinar with interactive Q&A VA Benefits and Medicaid Eligibility Meeting Complex Requirements for Benefits Qualification and Application THURSDAY, FEBRUARY 16, pm Eastern 12pm Central 11am Mountain 10am Pacific Today s faculty features: Yale S. Hauptman, Atty, Hauptman & Hauptman, Livingston, N.J. Laurie A. Hauptman, Atty, Hauptman & Hauptman, Livingston, N.J. The audio portion of the conference may be accessed via the telephone or by using your computer's speakers. Please refer to the instructions ed to registrants for additional information. If you have any questions, please contact Customer Service at ext. 10.
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5 V.A. Aid & Attendance Benefits 5
6 World War II Korean War Dec 7, 1941 Dec 31, 1946 June 27, 1950 Jan 31, 1955 Vietnam War Aug 5, 1964 May 7, 1975 Feb 28, 1961 if served in Vietnam 6
7 To Qualify for Pension: the Wartime Veteran must have served in the U.S. Armed Forces and. Served at least 90 days active duty Served at least one day during wartime Was honorably discharged 7
8 To Qualify for Pension: (Continued) Is over 65 years old, blind or disabled Has substantial recurring, unreimbursed Medical Expenses Has Limited Household income and assets to pay medical expenses Has Expectancy of living and paying future medical expenses 8
9 Basic Criteria for Need Regular Aid & Attendance: Inability to dress/undress Inability to keep oneself presentable Inability to feed oneself Inability to attend to the wants of nature An incapacity that requires assistance 9
10 Definition of Housebound that triggers qualification: Substantially confined to home or premise Due to disability or disabilities Reasonably certain to last for life 10
11 Proof of Medical Expenses Needed A Physician must provide a diagnosis supporting the scope of care and corresponding expenses being provided 11
12 The Net Worth Limitation Exempt Assets: Your house Your car Your household and personal goods 12
13 Countable Asset Limitation About $80,000 for a couple About $40,000 for a single person 13
14 The Critical Calculation: Gross Household Income Recurring Unreimbursed Medical Expenses(UME) Income for Veteran Administration Purposes (IVAP) 14
15 Maximum Available Pension Resource (MAPR) MAPR is the maximum available pension per category of need 15
16 Special Monthly Pension Rates Paid to Veterans Age 65 or Older, Permanently and Totally Disabled, or a Surviving Spouse Permanently and totally disabled veteran in need of regular aid and attendance MAPR * MMC $20,436 $1,703 With one dependent Surviving spouse $24,228 $2,019 $13,128 $1,094 16
17 Case Study 1: Married Couple, Vet needs A&A Couple s Gross Income: $45,000 UME (home care, prescriptions, co-pays): $57,600 $(12,600) 17
18 Case Study 1: (continued) MAPR: $ 24,228 (IVAP): $(12,600) Rounded to $0 Couple will receive $2,019 monthly Benefit, tax free! When IVAP is less than MAPR a benefit may be awarded 18
19 Case Study 2: Widow of Veteran Gross Income: $18,000 UME (home care, prescriptions, co-pays): $15,000 $3,000 19
20 Case Study 2: (continued) MAPR: $ 13,128 (IVAP): $3,000 Partial Benefit!: $10,128 When UME fails to meet or exceed Gross Income, a partial benefit is available. When IVAP is greater than MAPR NO benefit is awarded 20
21 Any VA penalty for gifting assets? VA currently has No Penalty Period of ineligibility for gifting excess assets to other family members 21
22 Should one give assets away to qualify? The answer depends on: Family dynamics Life expectancy Likelihood of increased future medical expenses Tax consequences Financial benefit vs. financial loss The Medicaid Trap caused by gifts within 5 years to nursing home need 22
23 Beware the Medicaid Trap! If one needs Medicaid within 5 years of any gift, he or she will be penalized by a period of Medicaid benefit ineligibility! 23
24 How Does Medicaid Work? For A Single Person Exempt Assets House Countable Assets Almost Everything Else Car Funeral Life Insurance Household Goods 24
25 A Single Person Example $100,000 $2,000 25
26 Married Couple (Example) $500,000 $219,080 (John) $109,560 (Sally) $109,560 John & Sally Smith $2,000 26
27 Look Back Period 5 Years Penalty Starts When: In Nursing Home (or need nursing home level of care) Otherwise Eligible $2,000 27
28 All Trusts Are Not Created Equal Revocable Living Trust Credit Shelter Trust Irrevocable Life Insurance Trust Spend Thrift Trust Income Only Type Trust Veterans Eligibility Trust 28
29 Trust to Qualify for Medicaid Irrevocable Principal cannot be distributed Income typically can be distributed This is a problem for qualification for VA benefits under the relinquishment rule VA will count the trust assets under VA asset rules 29
30 Veterans Eligibility Trust Can be grantor trust or not Income payable to lifetime beneficiaries and not to grantor Assets in trust not countable for VA purposes 30
31 Veterans Eligibility Trust (Continued) Home can be placed in trust and qualify for Section 121 exclusion Limited testamentary power of appointment to allow for step up in basis upon death 31
32 How is VA benefit treated by Medicaid Aid and Attendance is NOT treated as income for Medicaid eligibility purposes Other VA benefits are treated as income Check your state s Medicaid regulations 32
33 How is VA benefit treated by Medicaid (continued) However VA benefit is available to be used towards care when on Medicaid Once VA knows you are receiving Medicaid they will reduce pension to $90 per month 33
34 V.A. Aid & Attendance Tips Fax VA Applications Dementia issues are a red flag Waive 60 day due process period Involve local Congressman 34
35 V.A. Aid & Attendance Tips (Continued) Healthy veteran with sick spouse can collect Expediting a claim if claimant is on hospice Veterans that received honors may get preferential treatment 35
36 Be Nice To Me I Pick Your Nursing Home! How to Provide For Your Parent s Care Without Going to the Poorhouse or Nuthouse One of the most challenging parts of elder law is explaining what we do and how we can make a real difference in our clients lives $23.97 (Plus Shipping and Handling) Grow your practice New way to communicate what we do to prospects, clients, and our network of referral sources An amazing tool to educate the uncommitted prospect To Order Your Copy Today Go To 36
37 Yale S. Hauptman Laurie A. Hauptman HAUPTMAN & HAUPTMAN, P.C. 570 West Mt. Pleasant Avenue, Suite 101 Livingston, NJ (973)
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