Understanding assisted living benefits for Veterans

The U.S. Department of Veterans Affairs offers a wide range of benefits and programs to Veterans of all ages. These programs can help Veterans find and afford health care and housing, pursue an education, and access mental health counseling and services, among other forms of support.

Older Veterans may be able to use their VA benefits to help pay for aging care. Their spouse or dependent may also qualify for assistance. Every bit of support can help with the cost of assisted living and other care options, so it’s worth finding out whether you or your loved one may be eligible for VA benefits.

VA care benefits have different eligibility requirements, which can make them difficult to navigate. Here, we’ll focus on benefits available to older Veterans, particularly those that may apply to assisted living and other aging care services.

If you need to find an assisted living community right away, the information below can help you understand which VA benefits may apply.

[h2] General VA benefits: service-connected disability benefits

Service-connected disability benefits provide a monthly payment to a Veteran who was injured while on active duty or whose pre-existing condition was aggravated by their service. The VA assigns a percentage rating based on the severity of the disability.

For example, you may have a single rating of 10% or multiple individual ratings adding up to 70% or more. Some people have individual ratings totaling 120% or more, but they’ll only be paid at the 100% rate.

Each percentage rating carries a dollar value set by law. The rating must come from an exam at a VA Medical Center (VAMC), known as a compensation and pension, or C&P, exam. You must be enrolled in the VA Medical System to request this exam. The VAMC will contact you to schedule it, and it’s important to attend the appointment.

If you’ve been seeing a primary care physician, bring your medical history to support your disability claim. Service-connected disability benefits aren’t limited to older Veterans, but you or an older loved one may qualify, so be sure to investigate.

VA benefits for older Veterans

Three VA benefits commonly help older Veterans:

• Basic Pension/Improved Income: This monthly stipend is designed for healthy, low-income Veterans over age 65.

• Aid and Attendance Benefit (A&A): This VA benefit is intended to help Veterans over age 65 who need support with activities of daily living (ADLs), such as dressing, eating, and bathing. You may also hear it called the “VA assisted living benefit” or “VA elder care.” That’s likely because assisted living communities provide help with ADLs, but the benefit can apply to home care as well as care in a community.

• Housebound: This VA benefit can help Veterans over age 65 who have a 100% disability rating and can’t leave their home.

More details about VA health care benefits

A&A and Housebound pension payments exceed the Basic Pension benefit. You must qualify for the Basic Pension before you can be considered for A&A or Housebound benefits. In other words, you must be considered low-income to qualify for A&A or Housebound benefits.

Other VA benefits, including service-connected disability benefits, may count as part of your monthly income when the VA determines Basic Pension eligibility. Consider consulting a VA representative to understand which benefits you should apply for.

[h2] Veterans homes: assisted living and other care options

Veterans can receive long-term care in several types of homes or communities. One main option is a Community Living Center (CLC), commonly referred to as a VA nursing home, which offers skilled nursing care.

Veterans may stay at a Community Living Center for a short time while recovering from an illness or surgery. Veterans who need long-term medical care may remain there for the rest of their lives. Although many CLC residents are older Veterans, these homes serve Veterans of all ages.

State Veterans homes are operated by individual states rather than the VA, although the VA certifies and surveys them every year. Services vary by state and may include adult day care, skilled nursing, and long-term rehabilitation programs that help address homelessness and teach Veterans new skills.

Who qualifies for a VA assisted living community or nursing home?

CLCs and state Veterans homes typically require a minimum length of service, an honorable discharge, and enrollment in the VA health system. Additional requirements may apply, especially at state Veterans homes, because each state sets its own eligibility rules. Availability is limited, and Veterans with the greatest medical and financial needs are often prioritized.

Eligibility for VA benefits for older Veterans

Who qualifies for VA benefits? The answer depends on the benefit and your service history. According to the VA, you may be eligible for VA health care benefits if you served in the active military, naval, or air service and didn’t receive a dishonorable discharge.

Eligibility for basic VA health benefits may depend on when you served and the length of your service:

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

Can service requirements change?

Yes. The service requirements change in certain situations:

• 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 caused or worsened 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 requirements above, as well as the requirements for the specific benefit. You can’t receive A&A and Housebound benefits at the same time.

Veterans who receive a VA pension and Social Security Disability Insurance, and who spend most or all of their time at home because of a permanent disability, qualify for the Housebound pension. “Home” doesn’t necessarily mean a private residence. It could also mean an assisted living or skilled nursing community.

Your disability doesn’t have to be related to your military service for you to qualify for the Housebound pension. To qualify for A&A,, you must meet at least one of the following requirements:

• You need help with activities of daily living, such as dressing or toileting.

• Or, you’re confined to bed all day or for most of the day.

• Or, you live in a nursing home, skilled nursing community, or assisted living community because of mental or physical disabilities.

• Or, you 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 about Medicare and Medicaid:

If you’re approaching age 65, you may be wondering whether you need to enroll in Medicare if you already have VA health care. These systems provide different coverage, which may make it helpful to have both. If your VA benefits are ever dropped, such as because of a decrease in federal funding, you’ll already have Medicare coverage in place.

Although it’s unlikely that you’ll qualify for both VA benefits for older Veterans and Medicaid at the same time, you should consider both before applying. Veterans who need in-home care or assisted living may be better served by Housebound or Aid and Attendance coverage, while those who need skilled nursing care may be better served by Medicaid. Veterans’ spouses may also qualify for Medicaid, so remember to investigate that option for them.

[h2] Can a spouse receive Veterans benefits and health care?

Married Veterans who are sick or disabled and receive service-connected disability benefits may be able to add Aid and Attendance for their spouse to their monthly payment. The spouse must demonstrate a need for A&A, and the Veteran must have a disability rating of at least 30% for a spouse to claim A&A benefits through the Veteran’s service-connected disability.

This may be a small amount that won’t cover every care need, but each dollar can make a difference when you’re paying for care.

Other care programs may provide health care to Veterans’ spouses, dependents, and family caregivers. TRICARE offers comprehensive health care coverage to eligible family members of an active-duty, retired, or deceased service member, National Guard soldier, Reservist, or Medal of Honor recipient.

If you don’t qualify for TRICARE, you may be able to receive partial coverage for certain health care services and supplies through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

You can also explore other programs that may help Veterans’ family members..

Other VA benefits for spouses

Surviving spouses may receive several types of benefits after their Veteran spouse dies.

• Dependency and Indemnity Compensation (DIC): This payment should be made automatically to a surviving spouse if the Veteran had a 100% service-connected disability rating at the time of death and the cause of death can be linked to the reason the Veteran received that rating.

• Survivor’s Pension: These monthly payments are available to qualified surviving spouses and unmarried dependent children of wartime Veterans who meet certain income and net worth limits.

How do you apply for VA benefits for older Veterans?

You may be used to finding, completing, and submitting forms online, but VA benefits can be complex. For this reason, the VA strongly recommends working with an accredited representative when applying for any VA benefits you may qualify for. Veterans benefit planners are usually employed by nonprofit organizations and won’t charge for their help with the application process.

No one can legally charge you for helping prepare an initial VA benefits application, so be cautious of anyone who requests a fee for this service. If your claim is denied, you may want to hire an attorney to determine whether the decision can be overturned, but legal services typically aren’t free.

As tens of thousands of families can attest, this process isn’t easy to navigate alone. Many applicants are denied, while others give up. In October 2018, the application grew from roughly 6 pages to 26 pages, requiring applicants to meet and supply the burden of evidence.

Wondering whether you’re eligible?

Veterans Benefits Aid Counsel helped create this document. You can call the organization at (888) 388-1404 for a no-cost pre-filing consultation. Contacting the organization doesn’t indicate that you intend to file a claim. It’s simply an opportunity to learn more.

Make sure any person or organization helping or advising you with a claim holds current VA accreditation through the Office of General Counsel. The VA accredits only attorneys, Veterans service officers, and claims agents.

If someone isn’t accredited or can’t provide proof of accreditation, be cautious about accepting their advice or assistance. Anyone who helps someone file a claim without VA accreditation is violating federal law.

This also applies to someone who states or implies that they’re accredited and offers to prepare or advise you on a claim, even if an accredited person ultimately files the claim.

The Office of General Counsel accredits individuals to help protect the person filing the claim. Check OGC accreditation here.