Understanding Assisted Living Benefits for Veterans

The U.S. Department of Veterans Affairs offers a wide variety of benefits and programs to Veterans of all ages. These programs can help Veterans find and afford healthcare and housing, pursue an education, and find mental health counseling and services, to name just a few. 

Senior Veterans may be able to draw on the VA benefits available to them to help pay for senior care. Additionally, their spouse/dependent may be eligible to receive some assistance as well. Every little bit can help when covering the cost of assisted living and other care options, we encourage you to investigate whether you or your loved one may be eligible for VA benefits.

These various VA care benefits have different eligibility requirements and can sometimes be difficult to navigate. Here, we’ll be focusing on the VA benefits that seniors can draw on, particularly those that can be applied to assisted living and other senior care services.

If you know you need to find an assisted living community immediately, keep reading!

These benefits are a monthly payment made to a Veteran who suffered an injury while on active duty or had a pre-existing condition aggravated by their service. The severity of the disability is given a specific percentage rating.

For example, you may have a single rating of 10% or multiple individual ratings adding up to 70% or more. Some individuals carry 120%+ ratings when totaled but will only be paid the 100% rate. 

Each percentage rating carries a designated dollar value set by law. The rating must come from a VA Medical Center (VAMC) exam, called a C & P exam (short for “compensation and pension”). You must be enrolled in the VA Medical System to request this exam. The VAMC will contact you for the exam, and it’s critical to make sure you attend this appointment.

If you have been seeing a primary care physician, take your medical history with you to support your claim for disability. Although service-connected disability benefits are not limited to senior Veterans, it's possible you or your elderly loved one might qualify, so be sure to investigate. 

There are three VA benefits that commonly help seniors.

• Basic Pension/Improved Income: This monthly stipend is designed for healthy, low-income Veterans over 65.
• Aid and Attendance Benefit (A&A): This VA benefit is meant to help senior Veterans over 65 who need help with the activities of daily living (ADLs), such as dressing, eating, and bathing. Keep in mind that this benefit in particular is sometimes referred to by other terms like “VA assisted living benefit” or “VA elder care,” probably because help with ADLs is exactly what assisted living communities provide, but this benefit can be used for home care as well as care in a facility.
• Housebound: This VA benefit can help Veterans over 65 with a 100% disability rating who cannot leave their home.

More Details on VA Health Care Benefits

Both A&A and Housebound pensions exceed the Basic Pension benefit, and you must qualify for the Basic Pension in order to be considered for A&A or Housebound. In other words, you must be considered low-income to be eligible for A&A and Housebound benefits. 

Keep in mind that other VA benefits, like service-related disability benefits, can be considered part of your monthly income when the VA calculates your basic pension eligibility. It’s best to consult with a VA representative to determine what benefits you should apply for.

There are a few different types of homes or facilities where Veterans can receive long-term care. One main type is Community Living Centers (CLC), commonly referred to as VA nursing homes that offer skilled nursing care.

Veterans might stay at Community Living Centers for only a short time (while recovering from illness or surgery, for example), or, for those who need long-term medical care, for the rest of their lives. While many Veterans living in CLCs are seniors, these homes aren't specifically designed for senior living: they are there to help Veterans of all ages.

State Veterans homes are operated by individual states, not the VA itself, though they are VA certified and surveyed by the VA every year. Each state’s Veterans homes can provide different care, from adult day care and skilled nursing to long-term rehabilitation programs that help combat homelessness and teach Veterans new skills.

Who Qualifies for a VA Assisted Living Nursing Home?

CLCs and state Veterans homes typically require a minimum length of service, an honorable discharge, and enrollment in the VA health system, but there are more requirements on top of these, especially for state Veterans homes as each state has different eligibility requirements. Availability is limited, and Veterans with the greatest medical and financial needs are often prioritized.

So, who qualifies for VA benefits? The VA states that you may be eligible for VA healthcare benefits if you served in the active military, naval or air service and did not receive a dishonorable discharge.

Your eligibility for basic VA health benefits might depend on when and how long you served for:

If you enlisted after September 7, 1980, or entered active duty after October 16, 1981, you must have served 24 continuous months, or your full active duty period

Can Service Requirements Change?

Yes, service requirements change if:

• If you served before September 7, 1980, there is no minimum duty requirement
• If you were discharged for a hardship or “early out,” there is no minimum duty requirement
• If you were discharged for a disability that was caused or made worse by your active-duty service, there is no minimum duty requirement

Additional Eligibility Requirements

Housebound and Aid and Attendance pensions have additional eligibility requirements. Veterans must meet the above requirements and these in order to receive Housebound or Aid and Attendance benefits. Note that you cannot receive both A&A and Housebound benefits at the same time. 

Veterans who receive a VA pension and Social Security Disability Insurance, and spend most or all of their time at home due to a permanent disability, are qualified for the Housebound pension. This doesn’t necessarily refer to a private home, it could mean an assisted living facility or skilled nursing community.

Also, your disability does not have to be related to your military service in order to be eligible for the Housebound pension. To qualify for A&A, you must:

• Need help with activities of daily living (like dressing or toileting)
• OR, be confined to bed all day or most of the day
• OR, be a patient in a nursing home (skilled nursing facility) or assisted living community due to mental or physical disabilities
• OR, have 5/200 vision or less in both eyes even with glasses or contact lenses (or a concentric contraction of the visual field to 5 degrees or less)

A note on Medicare and Medicaid:

If you're approaching 65, you may be wondering about Medicare: do you need to sign up for it if you already have VA healthcare? These two systems provide very different coverage, making it a good idea to have both. And if your VA benefits are ever dropped (due to a decrease in federal funding, for example), you'll have Medicare coverage in place already.

While it's unlikely that you'll be eligible for both Veterans elder benefits and Medicaid at the same time, you should consider both before applying. Veterans who need in-home care or assisted living will be better off with Homebound or Aid and Attendance coverage, while those who need skilled nursing care are probably better served by Medicaid. Spouses of Veterans might be able to take advantage of Medicaid, too, so don't forget to investigate it for their sake.

Married sick or disabled veterans receiving service-connected disability benefits can have Aid and Attendance for their spouse added to their monthly payment. The spouse must be able to demonstrate the need for A&A, and the Veteran must be at least 30% rated for a spouse to claim A&A benefits under the Veteran’s service-connected disability.

Unfortunately, this is a small sum, and not enough to cover all care needs, but every dollar counts when it comes to care.

Additionally, there are other care programs that can provide healthcare to spouses, dependents, and even family caregivers of Veterans. TRICARE can provide comprehensive healthcare coverage to the eligible family members of an active-duty, retired, or deceased service member, National Guard soldier, Reservist, or Medal of Honor recipient.

If you do not qualify for TRICARE, you might be able to receive partial coverage for some healthcare services and supplies from The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

Take a look at some other programs that might be able to help family members of veterans.

Surviving spouses can receive a few types of benefits after their veteran spouse has passed.

• Dependency and Indemnity Compensation (DIC): This payment should be made automatically to a surviving spouse whose Veteran spouse carried a 100% service-connected disability rating at the time of death and whose cause of death can be linked to why they were granted the 100% rating.
• Survivor’s Pension: These are monthly payments to qualified surviving spouses and unmarried dependent children of wartime Veterans who meet certain income and net worth limits.

In our digital age, we’re used to being able to find, fill out, and submit forms online, but VA benefits can be very complex. For this reason, the VA strongly recommends that you work with an accredited representative to apply for any and all VA benefits that you may qualify for. Veterans benefit planners are usually employed by non-profit organizations, and won’t charge you for their help with the application process.

No one can legally charge for helping to prepare VA benefits applications, so be wary of anyone who tries to charge a fee for their services. If your claim is denied, you may want to consider hiring an attorney to see if this decision can be overturned, but their services are typically not free.

As tens of thousands of families can share with you, it’s not easy to make this trek alone. Many are denied, and others just give up. In October 2018, the application went from roughly 6 pages to 26 pages as it now requires the burden of evidence to be met and supplied.

Curious About Your Eligibility?

If you want to discuss where or even if you are on the eligibility spectrum for benefits, Seniorly has worked with Veterans Benefits Aid Counsel on the creation of this document. You can call them at (888) 388-1404. They would be proud to conduct a no-cost pre-filing consultation. Contacting them in no way is an expression of your intent to file, merely to learn.

Make sure that anyone or any organization assisting or advising you with a claim holds current VA Accreditation by the Office of General Counsel. The VA accredits attorneys, Veteran service officers, and claims agents only.

If they are not accredited and/or are unable to produce their accreditation, then be very circumspect of their advice and offer of assistance. An individual is in violation of federal law if they assist someone with filing and are not accredited by the VA.

This violation also applies to individuals who state or give the false impression that they are accredited, and they offer to help prepare and give advice on a claim, but the actual claim itself is filed by an accredited individual.

There is a reason the OGC accredits individuals, and it is to protect the claimant: check OGC accreditation here.