FROM ElderCareMatters.com “What long term care benefits does the VA pay for?”

Question:  What long term care benefits does the VA pay for?

Answer:  The VA has a benefit called the Veteran’s Improved Pension, commonly known as the VA Aid & Attendance Benefit.  In order to qualify for the Veteran’s Pension Benefit, the veteran must not have been dishonorably discharged, must have served at least 90 days active duty with at least one day served during a declared state of war, and must be either disabled or over age 65.  Widows of veterans may also qualify.  Applicants must meet certain income and asset limitations to qualify, and they must need assistance with Activities of Daily Living (ADLs) such as eating, bathing, and dressing.  This benefit can help married veterans may qualify for up to $24,239 of tax free assistance annually.  This money can be used to cover the costs of care in the home, in an assisted living community, or in a nursing home. 

If you think that you or a loved one might qualify for benefits, the next step would be to enlist the service and advice of an experienced Veterans Administration Accredited attorney who understands the Pension Benefit, as well as Medicaid planning rules and other estate planning issues.  Advisors such as a VA accredited attorney and a knowledgeable, experienced financial planner can help veteran households rearrange assets, make legally effective transfers, and assist with other estate planning needs in order to qualify a veteran household for a pension benefit.  It is extremely important that you involve an attorney who has experience with Medicaid planning if you plan on moving or otherwise rearranging assets in order to qualify for the Veteran’s Pension Benefit.  There is a high probability that the veteran, the spouse, or the surviving spouse of a veteran household may need nursing home care in the future.  Such care is very expensive and the individual’s income plus the veterans benefit rarely pay for the cost of a nursing home.  This means the veteran may have to rely on Medicaid to cover the deficit.  Assets reallocated to qualify for VA benefits could create penalties for Medicaid eligibility, underscoring the importance of planning for the possibility of having to apply for Medicaid in the future. 

In addition to the Aid and Attendance Benefit, the VA in its various facilities around the country will provide nursing home care the qualifying veterans.  However, the number of beds are very limited.  The VA provides service-connected disability ratings that range from 10% to 100%. Those veterans who are 100% disabled because of the service-connected injury or illness will receive priority for admission with priority moving down the rating scale.  In addition to the beds available in VA operated facilities in some states the VA has contracted with other nursing homes to make beds available to qualifying veterans.

To find Elder Care Professionals near you who can help you with these elder care matters, go to:  ElderCareMatters.com - America’s National Directory of Elder Care / Senior Care Resources for Families.

Henry C. Weatherby, Esq., CLU, ChFC, CEBS
Weatherby & Associates, PC
Connecticut State Coordinator – ElderCareMatters.com

Landmark Jimmo vs. Sebelius Settlement Helps Medicare Patients Receive Skilled Nursing Care

No longer do individuals have to show "improvement" for Medicare to pay for the cost of their skilled care after hospitalization:


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New Bottom Limit of MMMNA Announced

The Department of Health and Human Services has announced the new poverty income guidelines for 2013. The new guidelines mean that the lower limit of the minimum monthly maintenance needs allowance (MMMNA) will rise to $1,938.75 in the 48 contiguous states and the District of Columbia, effective no later than July 1, 2013. The current amount is $1,891.25.

The new figure will be $2,422.50 in Alaska and $2,231.25 in Hawaii. The minimum MMMNA is 150 percent of the monthly poverty guideline for a couple.

Do You Find Annuities Confusing?

FROM www.medicaidannuity.com:

You're not alone. If you're not an insurance agent annuities can be confusing. I'm frequently asked questions regarding the difference of annuities, and how the difference kinds are treated for eligibility purposes. What purpose do they really serve? What kind is appropriate? How do you tell the difference between all the types?

Why Use an Annuity?
The primary reason for using an annuity is to convert excess assets into an income stream. Thus, the problem assets, whether they consist of cash, checking and savings accounts, stocks, bonds, mutual funds, cash value life insurance, or an IRA, can be converted into an annuity, without jeopardizing eligibility. Additionally, using certain types of annuities can provide a safe investment vehicle when preplanning for Medicaid or gifting assets.

Immediate Annuities
An immediate annuity is a financial contract that delivers regular payments from an insurance company to the payee that begins soon after the signing of the contract - there is no accumulation period. For Medicaid purposes, if the immediate annuity meets certain restrictions outlined in the Deficit Reduction Act of 2005, it is considered income only. For Veterans Benefits purposes, an immediate annuity is considered income only regardless of its provisions.

Tax-Deferred Annuities

A tax-deferred annuity is an investment with an insurance company which continues to grow until the owner makes a complete withdrawal or annuitizes the contract. Established under § 403(b) of the Internal Revenue Code, tax-deferred annuity owners have the opportunity to accumulate funds on a tax-deferred basis. Contributions and the investment returns can grow quickly in that taxes are deferred until the owner receives the funds. For Medicaid and Veterans Benefits purposes, a tax-deferred annuity is a countable asset, which becomes part of the applicant or spouse's net worth. Tax-deferred annuities are primarily used as investment vehicles in preplanning for Medicaid, or in gifting assets.


Copyright ©2013 Krause Financial Services

Beautiful...

My dear girl, the day you see I'm getting old, I ask you to please be patient, but most of all, try to understand what I'm going through. If when we talk, I repeat the same thing a thousand times, don't interrupt to say: "You said the same thing a minute ago"... Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep.

When I don't want to take a bath, don't be mad and don't embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl?

When you see how ignorant I am when it comes to new technology, give me the time to learn and don't look at me that way ... remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life's issues every day... the day you see I'm getting old, I ask you to please be patient, but most of all, try to understand what I'm going through.

If I occasionally lose track of what we're talking about, give me the time to remember, and if I can't, don't be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you.

And when my old, tired legs don't let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don't feel sad... just be with me, and understand me while I get to the end of my life with love. I'll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I've always had for you, I just want to say, I love you ... my darling daughter.

Original text in Spanish and photo by Guillermo Peña.
Translation to English by Sergio Cadena

New VA Pension Rates for 2013

From Krause Financial (www.medicaidannuity.com): LINK is at the end of post.

For the Veteran

Service Pension $1,037
One Dependent $1,359

Housebound $1,259
One Dependent $1,570

Aid and Attendance $1,731
One Dependent $2,053

For the Surviving Spouse

Death Pension $695
One Dependent $911

Housebound $851
One Dependent $1,110

Aid and Attendance $1,112
One Dependent $1,327

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"I Have to Make Medicaid a Beneficiary?!"

From Krause Financial (www.medicaidannuity.com): Link at end of article...

"Then what's the point of using a Medicaid Compliant Annuity?" I hear this quite often, in both working with newer elder law attorneys and families of the elderly.  With the state Medicaid agency required to be a beneficiary, then doesn't it make the purchase moot?

Not necessarily.  Consider these three common planning scenarios:

1: Individual Gifting Scenario.

An individual makes a gift and purchases a Medicaid Compliant Annuity.  The Medicaid Compliant Annuity is structured to provide income throughout the divestment penalty period associated to the gift.  Designating the state Medicaid agency is one of the requirements for the purchase of the Medicaid Compliant Annuity not to be deemed a transfer for less than fair market value.  However, in the event the individual predeceases the Medicaid Compliant Annuity, the Medicaid agency would not be entitled to any of the residual benefits remaining in that the agency did not provide any medical assistance benefits to the individual due to the divestment penalty period.  As such, the individual's intended beneficiaries would be entitled to receive any residual benefits remaining in the Medicaid Compliant Annuity.

2: Individual with a Diminished Longevity.

In a case where an individual has a very short life expectancy a stand-alone Medicaid Compliant Annuity may provide a greater advantage than a gifting plan (aka a half-a-loaf plan).  By purchasing a Medicaid Compliant Annuity over the individual's life expectancy, he or she is immediately eligible for Medicaid benefits.  The Medicaid Compliant Annuity payout becomes the applicant's Medicaid copay.  This type of planning is traditionally only advised if the applicant is expected to life for 12 months or less.  When the individual predeceases the Medicaid compliant Annuity, the state Medicaid agency is entitled to recover from the residual benefits up to the amount of Medicaid paid on behalf of the applicant.  If the individual passes shortly after the annuity has commenced, the state's claim amount will be very small, leading to a greater remainder amount for intended heirs.  But why even proceed with the annuity?  Why not just continue to privately pay until the individual passes? Because the state's claim amount will be at the Medicaid rate, not the private pay rate.  Even after repaying the state Medicaid agency, the family will have paid less than had they done zero planning at all.

3: Spousal Medicaid Compliant Annuity Planning.

In a traditional community spouse case, funds in excess of the community spouse resource allowance will be structured in a Medicaid Compliant Annuity owned by the community spouse.  The community spouse is usually entitled to keep all income, regardless of the amount.  However, the community spouse is also usually required to designate the state Medicaid agency as a beneficiary up to the amount of Medicaid benefits paid on behalf of the institutionalized spouse.  In light of this, should the community spouse predecease the Medicaid Compliant Annuity the state Medicaid agency is able to reocver what has been paid on behalf of the institutionalized spouse, leaving very little to potentially be transferred to intended heirs.  Due to this fact, more and more community spouse Medicaid Compliant Annuities are seeing shorter terms, dependent on the anticipated longevity of the community spouse.

As you can see, in most cases it is not a "lost cause" to utilize a Medicaid Compliant Annuity, even though the state Medicaid agency does need to be designated as a beneficiary. 

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