A portion of a VA benefit paid by apportionment to a dependent spouse or child is VA income to the dependent spouse or child. It is not a support payment from the designated beneficiary.
E-4311.2 $90 VA Pension and Institutional Setting
Revision 10-1; Effective March 1, 2010
If a veteran without a spouse or child or a surviving spouse without a child is covered by Medicaid for services furnished by a nursing facility, the maximum pension that can be paid to or for the veteran or surviving spouse for any month after the month of admission to such nursing facility is $90. This reduced pension is an aid and attendance allowance in all cases, and not income.
VA law (38 U.S.C. 5503) provides that the amount of the VA pension for an institutionalized Medicaid recipient having neither a spouse nor child (or in the case of a surviving spouse, having no child) cannot exceed $90 per month.
The $90 VA pension may not be used in determining what the person in an institutional living arrangement must pay toward the cost of care. The limited VA pension, up to the amount of $90, is not counted as income in the eligibility or co-payment budget.
There is no association between the reduced pension and the personal needs allowance (PNA). If a veteran has income from other sources, the income from other sources may be considered countable. HHSC is to perform the co-payment calculations to determine the amount of the veteran’s liability toward the cost of care.
Do not refer a person who is receiving the $90 VA pension in an institutional setting to apply for other benefits when it is to increase the VA payment for medical expenses since aid and attendance or housebound benefits are considered exempt income that does not affect eligibility or co-payment. If the person’s only income is the $90 VA pension, refer the person to the Social Security Administration for SSI.
See Section D-6351, VA Pension or Compensation.
Automation Requirements
Because of automation limitations, the VA $90 capped pension is included in the PNA calculation.
- For a non-SSI Medicaid recipient in an institutional living arrangement who does not have a VA pension capped at $90 per month, the total PNA will be up to the current maximum of $60.
- For a non-SSI Medicaid recipient in an institutional living arrangement who has a VA pension capped at $90 per month, the total PNA may be up to $150 ($90 VA plus up to $60 PNA).
- State supplementation is not allowed for a Medicaid recipient who is not an SSI recipient.
- The VA $90 capped pension and PNA calculation does not impact the Protected Earned Income Allowance.
In a situation in which a veteran does not have another source of income from which to deduct the $60 PNA, the PNA continues to be $90 and the co-payment is zero. In a situation in which a veteran’s other source of income is less than $60, the PNA will be $90 plus the amount of other income, not to exceed $60. There is no state supplement to bring the PNA up to $60 if the veteran does not have other income from which to subtract the PNA. The PNA deduction comes first in the order of all co-payment deductions, including those for incurred medical expenses (IME).
For SAVERR and TIERS, enter the VA pension capped at $90 per month as income.
If a person’s only income in a facility is the VA pension capped at $90 per month, certify the person for Medicaid, provided the person meets other program requirements, and refer the person for SSI.
