2435 VA Aid and Attendance Exclusion
Revision 08-4; Effective October 1, 2008
The VA pays an additional allowance to some disabled veterans, their spouses, widows or parents. This additional allowance is designated by VA as aid and attendance and is based on the individual's need for the regular aid and attendance of another person. If an individual is in a nursing home because of mental or physical incapacity, the VA presumes eligibility for aid and attendance.
§358.465(e)(1) — The department excludes aid-and-attendance allowances, housebound allowances, and VA reimbursement for unusual medical expenses in the income eligibility determination and applied income calculation because they represent medical expenses paid by a third party...
Do not include aid and attendance and VA reimbursement for unusual medical expenses as a part of the total VA benefit in Section II of Form H1000-A/B...
VA law (38 USC 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 client in a vendor living arrangement must pay to the facility toward the cost of care. The limited VA pension, up to the amount of $90, is not counted as income in the eligibility or applied income/copay budget. There is no interaction between the reduced pension and the personal needs allowance (PNA). If the veteran has income from other sources, the income from other sources may be considered countable for the purposes of applied income/copay. HHSC is to perform the applied income/copay calculations to determine the amount of the veteran’s liability toward the cost of care.
Because of automation limitations, the VA $90 capped pension will be included in the PNA calculation.
- For a non-SSI Medicaid recipient in a vendor 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 a vendor 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 will not be 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 the veteran does not have another source of income from which to deduct the $60 PNA, the PNA will continue to be $90 and the applied income will be zero. In a situation in which the 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 applied income/copay deductions, including those for incurred medical expenses (IME).
This is interesting - it is under Compensation but A&A can be an additional amount on top of Compensation:
2452.32 Compensation
The VA determines the designated beneficiary of a check based on the laws and regulations for payment of each benefit.
§358.455(c)(3)(C) — When veterans benefits are augmented for a dependent, the dependent's portion is not countable income to the recipient (the veteran or veteran's surviving spouse) of the check. If the dependent is the client, his portion is countable income to him.
Reference: For information about VA aid and attendance benefits, see Item 2435, VA Aid and Attendance Exclusion.
