Veteran currently receives $318/month in VA pension. Nursing home is telling him he can only keep $40 and must provide them with monthly check of $278. Have read a few articles and law (38 USC 5503 (d) that seemingly says pension should be reduced to $90 and belongs to veteran and nursing home should provide an additional $40 (Virginia) for a total of $130/mo. for personal needs allowance. Can anyone provide additional clarification?
1.VA pension, if that’s what’s he’s on, it’s viewed as income and yes all his monthly income less his states personal needs allowance must be paid to the NH as the required copay of SOC (share of cost). pNA varies by state, like for TX it was $60.
and
2. VA Aide & Attendance. the $90 stipend from VA happens IF they were on VA Aide & Attendance program and stopped A&A then applied for LTC Medicaid. You cannot have both VA A&A and Medicaid. Medicaid is better as it covers all costs. A&A has a max amount each mo (it used to be like $1400 but now varies by income) and even if it’s the max paid it cannot cover the 5k -10k a mo that a NH costs. So Medicaid is better. Sometimes if they have a sticky financial spend down to do, they keep the A&A during the spend down process..... like they have to do a settlement over a few months to lessen the penalty so they keep the A&A as between it, the settlement $ and regular monthly income they can cover the NH costs, then afterwards apply for Medicaid.
also and this is pretty important.... he MUST pay his copay to the facility.
Imo arguing with a NH over his copay will place him in jeopardy for staying in the facility and being eligible for Medicaid. The NH can send a non compliant letter to the state and stuff like this snowballs. Really you don’t want to go there. Basically once on Medicaid, all the $ they will ever have is that small personal needs allowance. That’s it. If he has bills or debts, he defaults on them unless family want to pay them.
If he was on A&A he gets an extra $90.
But otherwise, it’s just $40 from now on a mo for him.