MassHealth and the VA Aid & Attendance Program
If you qualify for Aid and Attendance, you should consider how the Aid and Attendance funds are viewed in by Medicaid in Massachusetts (MassHealth). The website for the Commonwealth of Massachusetts is www.mass.gov . First, it is important to understand what you have been award. A veteran or surviving spouse may not be qualified for any pension under the VA rules until they meet the medical and financial criteria for Aid and Attendance. However, once they meet the criteria, the award they are granted is comprised of Basic Pension (Maximum Annual Pension Rate (MAPR)) and Aid and Attendance. This is important because depending on your finances, Basic Pension MAY count against you for MassHealth - while the Aid and Attendance portion does not or, and this is the most likely senario, the entire amount might be counted as Aid and Attendance. Follow this link to the A&A Table on this website or check the figures on www.VA.gov.
MassHealth and the VA’s Aid and Attendance Pension:
Under Commonwealth of Massachusetts Regulation (CMR) 130, Chapter 520.008 Noncountable Assets - Noncountable assets are those assets exempt from consideration when determining the value of assets. It states in Chapter 520.008 "(G) Veterans' Payments. Veterans' payments for aid and attendance, unreimbursed medical expenses, housebound benefits, and enhanced benefits retained after the month of receipt, provided these payments are separately identifiable, are considered noncountable assets. Appreciated value and earned interest are also noncountable."
Under Commonwealth of Massachusetts Regulation (CMR) 130, Chapter 520.015 Noncountable Income - The following types of income are not considered in determining the financial eligibility of the applicant or member: "... (E) veterans' aid and attendance benefits, unreimbursed medical expenses, housebound benefits, enhanced benefits ($90 Veterans' Administration pension to long-term-care-facility residents, including veterans and their childless surviving spouses who live in a state veterans' home), or veterans’ benefits that are based on need and are provided by municipalities to resident veterans;..."
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What does MassHealth Exemption for VA Aid and Attendance funds mean for you?
Here is one example: The veteran is living in an assisted living and has $45,000 in assets. They qualify for the VA's Aid and Attendance benefit. We know from looking at the table that $659 per month is the Aid and Attendance enhancement and, as long as that amount is kept separately identified, it will not counted as a Medicaid asset should the veteran require nursing home care and eventually deplete his assets.
Therefore, each month after the receipt of his Pension check, the veteran should have $659 removed from his regular checking account and placed into a separate account where only Aid and Attendance funds and the interest it earns is kept.
Assuming other funds are countable assets for MassHealth purposes, the veteran should spend other funds first and in theory, be able to apply for MassHealth when all of his other assets are $2,000 regardless of the amount in his Aid and Attendance account.
Make sure you write the VA and ask them to breakout the components of your pension so you have proof of the Aid and Attendance component if ever challenged.
Nursing Home While private paying in a skilled nursing facility, the veteran or surviving spouse is still entitled to their Aid and Attendance pension as indicated by the criteria.
Once a recipient of Aid and Attendance is on MassHealth, the Aid and Attendance Pension is limited to $90 per month which is still $90 more per month than non-veterans are receiving.
Assisted Living While private paying in an Assisted Living facility, the veteran or surviving spouse is still entitled to their Aid and Attendance pension as indicated by the criteria - once they are on Group Adult Foster Care, if single, the award will likely be reduced to $90 per month. In the case of a married veteran, it is possible that the award will continue to the spouse.
In the Commonwealth of Massachusetts, veterans and their surviving spouses who are on Medicaid in an Assisted Living can receive additional funds from their town through the Veterans Services Officer - most are located at the Town Hall. These funds are excluded from being counted by Medicaid.
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