How Do VA Benefits Help With Assisted Living?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

As a veteran or the spouse of a veteran, you should be honored with the benefits afforded to someone who has sacrificed themselves for their country. But unfortunately, not everyone can qualify, as you have to apply for benefits. 

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A veteran who needs assisted living has reached a point where they can no longer manage at home. Paying for assisted living can be a challenge due to the cost of care in these communities.

There are VA benefits to help veterans who live at home, but sometimes that assistance may not be enough to keep someone safe. Some veterans may have chronic medical conditions that have worsened over time, or a sudden accident or illness prevents them from returning home.

A veteran or spouse of a veteran who has questions about whether they qualify for VA benefits should always ask and apply for relevant programs. The VA does not pay the cost for any assisted living community. Instead, there are VA programs that you may qualify to offset the cost of room and board and augment personal care costs. 

What Are the VA Benefits for Assisted Living?

Aside from the VA foster home program (also called a medical foster home), which we will discuss separately, these are the financial benefit programs for eligible veterans. All of the VA programs have complicated criteria and lengthy application processes. So be prepared to have all of the documentation you need so that you aren’t disqualified and have to start over.

VA Pension Program

The VA Pension Program pays a monthly benefit to veterans who meet age and income criteria. You might also be eligible as a surviving spouse or child of a deceased Veteran with wartime service. So, if you are an aging surviving spouse who needs assisted living, you might qualify for the monthly pension.

Aid and Attendance

The Aid and Attendance program pays an additional monthly benefit for veterans who need help with assisted living or at home. Assisted living communities have caregivers to offer further assistance, but usually at an increased monthly cost to the resident.

In some cases, residents in assisted living communities or other senior housing options end up paying out of pocket for additional caregiving through a private agency. If you qualify for the aid and attendance program, the extra funds are used for home caregivers contracted through the VA to assist you with daily living activities.

VA Medical Foster Home Program

The VA Medical Foster Home Program is a special program for veterans with significant medical needs. Medical foster homes are in private homes where a trained caregiver provides services to a few individuals who live together. 

The VA has to approve all medical foster homes and in some states, the program facility falls under the guidelines for assisted living. The program may be appropriate for veterans who would otherwise qualify for nursing home care but prefer a non-institutional setting with fewer residents.

Medical foster homes have supervision 24 hours a day, seven days a week. The caregivers help veterans with activities of daily living, such as bathing and getting dressed. While living in a medical foster home, veterans receive medical services from the program home based primary care, which provides nurses and other health care personnel on-site when needed.

How Do You Qualify?

The income, service, and disability requirements for each program are complex and unfortunately tend to change often. Some people use qualified veteran’s benefits specialists to help them navigate the application process.

The VA does not permit any individual or entity to charge you to apply for benefits. However, after your application has been approved for benefits, there may be some fees involved. Veterans Affairs has a list of accredited individuals and companies who are authorized to assist with the process.

Despite the option to get help, you may decide to go through the process without it. The VA websites have extensive information related to each program, so it is advisable to take a look to determine if you think you meet the criteria.

VA Pension Program Criteria

The program stipulates that a veteran who chooses to apply must be honorably discharged, and they must also have family income and net worth amounts that meet the limits set by Congress. The net worth and family income amounts also include any money or assets owned by their spouse.

It goes on to establish further parameters about one’s service, as well as being at least 65 years old, having a permanent and total disability, and be living in a nursing home in the long term. They must also be receiving Social Security Disability Insurance or other supplementary income. If a veteran meets the criteria, receiving a VA pension can be a big help with paying for costs of care in assisted living. 

Aid and Attendance

To meet the criteria for the aid and attendance program, there are specific physical needs and financial limitations that must be met:

  • You require help performing activities of daily living such as bathing, eating, or dressing.
  • You are confined to a bed.
  • You are in a nursing home.
  • Your eyesight is limited.

VA Medical Foster Home Program

First of all, there has to be a medical foster home available in your community, and if there is one, space in the program. The programs are only available in locations where there is a VA hospital, and you have to enroll in the VA home-based primary care program.

Since the program is intended as an alternative to nursing home care, eligible veterans need lots of help with activities of daily living such as ambulation, bathing and dressing, hygiene, medication management, and cooking. 

How Much Will the VA Typically Pay for Assisted Living?

The VA does not pay for assisted living directly. As a veteran, spouse, or adult child of a veteran, you must qualify for the programs listed above. These programs will pay a monthly benefit, making a significant difference in the out-of-pocket costs for assisted living and private care. The amount you can qualify for will depend on several factors.

VA Pension Program Monthly Benefit

To qualify for this program, the VA evaluates your income level and net worth. The VA has what is called your maximum amount of pension payable (MAPR). Your MAPR is based on how many dependents you have, if you’re married to another veteran, and if you also qualify for housebound or aid and attendance benefits. The amount ranges from about $14,000 to $23,000 a year, depending on whether you are eligible for the Aids and Attendants program as well.

Aid and Attendance

As previously mentioned, the aid and attendance is an additional pension amount based on medical need. The formula is complicated, but in 2020, the maximum benefit amount for a veteran who does not have a spouse or dependent child is $13,752 per year or $1,146 a month.

VA Medical Foster Home Program

Veterans pay out of pocket for this program, but it is about half of what a nursing home would cost. If you qualify for the other pensions mentioned, this will offset the cost. The amount you pay for the medical foster home program can vary between $1000-$3000 a month.

How Do You Apply for Care Through the VA?

Applying for care through the VA can be daunting. The VA does have advisors to help you with applications, but the better educated you are about all of the programs, the easier the process will be. Any monthly amount will help with the costs of assisted living.

1. Apply for VA Healthcare Benefits

There are eligibility criteria to be accepted for VA Healthcare Benefits. Even if you don’t qualify for the pension programs, there are benefits to being connected to the VA medical system, including in-and-outpatient healthcare, mental health services, and prescription drugs.

In other words, you can’t apply for the benefits programs without first being accepted into the VA medical system. Some veterans use the VA medical system exclusively for their healthcare needs, and other people use other systems in combination with the VA. 

2. Gather information

Before applying for any program, you will need your DD Form 214 which is your honorable discharge from the service. You may also want to consider doing a review of your financial situation. If your income and net worth are too high, you may not qualify for some programs. You will also need a copy of your tax returns. It is possible to use some medical expenditures to get your income down. 

3. Apply for Pension and other benefit programs

There are so many different types of programs to apply for that it can be mind-boggling! This page is a nice summary of all of the VA benefits programs and a portal to each one. And remember, if you or a loved one don’t qualify now, you may later as your situation changes.

VA Benefits Help with Assisted Living 

The VA medical system and the benefits that go with it are well worth the time to explore. Getting started might seem like a challenge, but if you or your loved ones qualify, it can make a significant difference in your cost of care going forward.


Sources:
  1. “Eligibility for Veterans Pension.” US Department of Veterans Affairs. https://www.va.gov/pension/eligibility/
  2. “Elderly Veterans.” US Department of Veterans Affairs. https://www.benefits.va.gov/persona/veteran-elderly.asp
  3. “What is a Medical Foster Home?” US Department of Veterans Affairs. https://www.va.gov/Geriatrics/pages/Medical_Foster_Homes.asp
  4. “Get Help Filing Your Claim or Appeal.” US Department of Veterans Affairs. https://www.va.gov/disability/get-help-filing-claim
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