Veterans Care Guide

VA Pension Benefits

Wartime veterans meeting age or disability criteria could qualify for supplemental income. Their assets and countable income must also fall under congressional limits. Veterans' maximum annual pension rate (MAPR) is based on the number of dependents, whether any disabilities qualify them for Aid and Attendance or Housebound, and whether they are married to another qualifying veteran. Veterans can receive the pension via direct deposit or a prepaid debit card.

 VA Aid and Attendance Benefits

Applicants who need the aid and attendance of a caregiver or those who are housebound might qualify for financial assistance on top of a VA pension. Some applicants can get Aid and Attendance or Housebound even when their income and assets disqualify them from a basic pension.

Housebound Benefits for Veterans

Individuals who are homebound can apply for the housebound benefit to supplement current compensation amounts. Income limits for this benefit are higher than for the basic pension. Thus, you may qualify for it even if you do not qualify for a basic pension.

You cannot receive both Housebound and Aid and Attendance. It is one or the other. Housebound allowances are for veterans or survivors who have a disability (or disabilities) leaving them housebound. However, they may still be able to leave their home, assisted living facility, or nursing home with a caregiver's assistance. Typically, they leave primarily or only for medical appointments.

Specially Adapted Housing Grants for Disabled Veterans

SAH grants give beneficiaries funds to create a barrier-free home environment to promote their daily independence and mobility. Those with service-specific disabilities could qualify for a maximum grant amount of $117,014 in the fiscal year 2024 to build or modify a home with features helpful for their specific disabilities.

Special Housing Adaptation (SHA) Grants for Veterans and Servicepersons

With the same intention and basic qualifications as SAH grants, SHA grants have a maximum benefit amount of $23,444 in fiscal year 2024. Recipients can use the money to buy, build, or change their permanent home. Like with SAH grants, they can use the money as many as six times over their lifetime.

Temporary Residence Adaptation (TRA) Grants

Temporary Residence Adaptation grants are available if you qualify for an SAH or SHA grant and live temporarily in a family member’s home that needs adapting. Maximum TRA grant amounts for fiscal year 2024 are $47,130 if you qualify for SAH grants and $8,415 if you qualify for SHA grants.

Home Improvements and Structural Alterations (HISA) Grant

These grants pay for medically necessary home alterations and improvements. Examples include installing roll-in showers, lowering kitchen countertops, widening doorways, improving plumbing, and installing permanent ramping. For those with service-connected disabilities, lifetime grants of up to $6,800 are available, while those with non-service-related disabilities can receive up to $2,000 in grants.

Applicant is bedridden due to illness with exception of leaving the home (with assistance) to receive medical treatments, therapies, and/or attend other essential appointments.

Applicant requires the aid of a caregiver or other individual to perform most of their activities of daily living (ADLs) such as bathing, taking medications, grooming, toileting, adjusting prosthetic devices, etc.

Applicant resides in a nursing home due to physical or mental incapacities such as any form of dementia.

Applicant has severe eyesight limitations in one or both eyes under current VA guidelines.

Loss or loss of use of both lower extremities that prohibit locomotion without aids such as crutches, cane, wheelchair, or braces (after September 11, 2001).

Loss or loss of use in a lower leg plus long-lasting effects of natural disease or injury (use of locomotive aids may be necessary).

Loss or loss of use of both upper extremities at elbow level or above.

Complete blindness (20/200 visual acuity or less)

Severe burn injuries.

The loss or loss of use of both hands or extremities below the elbow.

Severe burn injuries.

Breathing or respiratory injuries.

Financial Eligibility

Veterans or survivors must meet certain financial eligibility requirements to qualify for VA benefits. In 2024, the net worth limit is $155,356. The VA considers various types of income and assets such as:

• Disability and Retirement Payments
• Dividend and Interest Payments from Annuities
• Net Business Income
• Income from Eligible Dependents
• Total Assets (Not including the beneficiaries’ residence or vehicle)
• Annual Income

Some things such as Medicare Supplement Insurance premiums, unreimbursed medical costs, and Medicare premiums can reduce applicants' countable income.

Income Considerations for VA Benefits

Countable income after deductions determines an applicant's qualification status, at least as far as finances and assets. It's possible to have enough deductions for countable income to equal $0. In such cases, applicants should qualify for the maximum benefit level as long as they meet all other requirements.

Asset Limitations

While there is no set limit on what an applicant's net assets can be, the amount the VA generally allows in 2021 is about $130,773. This doesn't include the applicant's home (as long as they or a spouse resides there) and primary automobile. Applicants with more than $130,773 in assets such as stocks, cash, savings, and 401k distributions are typically denied.

However, having liquid assets under this amount does not necessarily mean an applicant will be approved. Furthermore, if an applicant is approved and eventually moves into a senior care facility, the house is reconsidered as an asset unless their spouse still resides in the home.

Clinical Eligibility for VA Benefits

Those seeking Aid and Attendance, home adaptation grants, or Housebound benefits must meet specific clinical requirements. To receive Aid and Attendance, the applicant generally must require the assistance of another person to perform activities of daily living such as performing hygiene routines, cooking, eating, toileting, taking medication, dressing, altering or adjusting prosthetic devices, protecting themselves from hazards in their current environment, etc.

Homebound applicants need assistance when leaving the home, which they typically do only for medically related appointments, emergencies, or other special circumstances. Applications are much more likely to be approved if this type of care is already in place along with documentation of such services and their costs. Those seeking home adaptation grants can find the requirements here and here.

Adult Day Services

Also known as adult day care, these facilities provide daytime supervision and assistance in a safe environment. There are generally age-appropriate activities, socialization opportunities, and meals. Adult day services allow primary caregivers to take a respite, continue to work, or have a break to run errands. Depending on the provider and the adult’s needs, the average daily cost of adult day care is about $98. Applicants can deduct these costs as medical expenses.

In-Home Care

In-home caregivers assist seniors with ADLs, housekeeping, cooking, medications, and errands. They also provide valuable socialization and companionship. The median pay for personal care aides in 2022 was $14.51 per hour, according to the Bureau of Labor Statistics. Location and whether the caregiver is hired directly or through an agency play big roles in how much seniors end up paying. Live-in or 24-hour caregivers cost more.

Applicants using certified private caregivers or a licensed home care agency can deduct these costs when applying for benefits.

Residential Care Homes

Also referred to as adult family care homes, senior group homes, adult foster homes, or board and care homes, these types of care communities are typically in a home environment with no more than 10 residents. Because of the homes' small size, seniors may receive more attention than at a larger facility. Costs vary widely for residential home care and often range between $2,500 and $5,000 per month. Aid and Attendance benefits may be used for such facilities if the home is licensed by the state the beneficiary resides in.

Memory Care

Memory care is available in many types of senior living communities. Such places should have the staff and facilities to assist residents with various forms of dementia such as Alzheimer's disease. Some facilities are designed specifically for memory care patients and include precautions such as extra-secure premises to prevent “wandering.” Staffers are trained to handle behavioral patterns and problems common among memory care patients. On average, memory care facilities cost about $5,000 monthly. Applicants residing in such communities will likely qualify for Aid and Attendance.

Nursing Home Care

Nursing homes offer high levels of supervision and medical care, making them ideal for bedridden patients, those with intense medical needs, or those who require feeding tubes or tracheostomies. The median cost of a nursing home semiprivate room is $8,929 a month nationally. Many nursing home residents are on Medicaid due to the exorbitant costs. If you are single, plan to enter a nursing home, and already have Medicaid, your VA Aid and Attendance benefits will top out at $90 per month. This makes Medicaid the better option to pay for care. However, those who are married or just on the cusp of being able to afford the care via their income may find Aid and Attendance benefits more helpful.

Free Assistance for VA Benefits Applicants

Free help is available for those wanting to apply for VA benefits such as Homebound, Aid and Attendance, and Housing Adaptation grants. Organizations such as the American Legion, the Veterans of Foreign Wars (VFW), and Disabled American Veterans (DAV) have staffers available for that purpose. Officers at regional VA locations can also answer questions about benefits and provide tips for filling out applications. For online advice and tips, head to VeteranAid.org.

Hiring Paid Consultants

There are accredited VA consultants trained to assist applicants. However, their ability to provide certain services depends on strict guidelines. These professionals can offer advice only with initial applications. Further, they cannot charge a fee to assist with the application unless unusual expenses apply or the person previously has been denied at least once. Ask at the beginning about any fees you may be charged to reduce the chances of surprises down the road.